Care Management Matters July/August 2013 by Care Choices Ltd

CMM CAREMANAGEMENTMATTERS

JULY 2013 £4.00

CARE IN 2023 What do you see?

Financial scrutiny Is CQC best placed for this?

Business Clinic

Health hotels, why not care homes?

Spotlight on… Care sector software

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in this issue

IN THIS ISSUE regulars 05

editor s welcome

Is it just me...?

Robert Chamberlain, Editor in Chief, addresses the cultural barriers that must be tackled to enable full integration of health and social care.

News

In Focus

Property News

Local Authority and Planning News

Corporate News

60 Seconds with...

Business Clinic

Sandie Keene, incoming President of ADASS answers our questions.

With proposals to explore health hotels to avoid bed-blocking, we ask our panel whether care and nursing homes would be a better solution.

Spotlight on...

Conferences

features 16

Care sector software.

Chris Tarry discusses plans for the CQC to scrutinise care home finances.

CMM reviews the NCF s 10th annual conference and the Derbyshire and Nottinghamshire Care Conference.

What s On?

Straight Talk

Looking to the future

More demand, less money ‒ what s got to give?

Simon Duffy shares his thoughts on supported living being an outdated model.

Feeling Settled ‒ Guidance for Providers and Commissioners

A new toolkit from NDTi to help improve the housing rights and security of tenure for people with learning disabilities.

What will the sector look like in 2023? CMM asks the question.

Martin Green summarises the recent ADASS report on budget cuts and explores the difficult conversations needed to cope with the reduced funding.

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Financial oversight of care homes ‒ will it work?

100,000 social care apprenticeships by 2017: issues for employers

With a drive to increase the number of apprentices in social care, Rhidian Hughes explores the issues for providers.

Welcome to the summer issue of CMM. It is my first issue returning as editor and I m enjoying reconnecting with old contacts and meeting lots of new faces too. So much has happened in the three years I ve been away and with forthcoming changes in policy and legislation it looks as though things will keep evolving for some time yet. As such, I ve pulled together some predictions of what the sector will look like in 2023. Informed speculation is always interesting so take a look at page 20 to find out if you agree with our commentators. Feel free to let me know your thoughts too, I m always interested. Also inside this month s issue, Chris Tarry of Carterwood looks at the proposals for CQC to scrutinise the finances of the biggest care providers. In an attempt to prevent another Southern Cross collapse, Chris considers whether the CQC is best placed to scrutinise and if the proposals will work in practice. His article starts on page 16. Martin Green sets out what he thinks needs to happen for the sector to be able to deal with increasing cuts to local authority budgets. He proposes radical change and difficult conversations on page 28. What would you propose? Finally, CMM is growing its portfolio of conferences, if you want a chance to meet like-minded providers, hear about the sector from those in the know and take away ideas for your business, turn to page 45 to see what we ve got coming up. And on that note, I ll see you in September.

Emma Morriss Editor

Follow CMM on Twitter @cmm_magazine

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contributors

CMM CAREMANAGEMENTMATTERS July 2013

Editorial and Production editor@caremanagementmatters.co.uk Editor in chief: Robert Chamberlain Editor: Emma Morriss associate Publisher: Matthew Tingey news Editor: Des Kelly design and Production: Lisa Werthmann, Jamie Harvey, Nick Cade & Holly Cornell adVErtiSinG sales@caremanagementmatters.co.uk 01223 207770 advertisement Manager: Tracey Diplock tracey.diplock@carechoices.co.uk Business development Manager: Paul Leahy paul.leahy@carechoices.co.uk SuBScriPtionS info@caremanagementmatters.co.uk To request your free copy of CMM call 01223 207770 www.caremanagementmatters.co.uk Care Management Matters is published by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters ÂŠ Care Choices Ltd 2013 iSBn: 978-1-909048-63-8 ccl rEF no: CMM 10.5

editorial panel Des Kelly OBE,

Mike Padgham,

Executive Director, National Care Forum

Chair, UKHCA

Professor Martin Green OBE,

David L Jones,

Chief Executive, English Community Care Association

Partner, Deloitte

Andrew Sidwell,

Paul Ridout,

Partner, GVA

Partner, Ridouts LLP

Andrew Barnsley,

Zoe Farrell,

Managing Partner, Nexus Corporate Finance LLP

Training Development Director, Catalyst for Care

contributors Professor Martin Green OBE, Chief Executive, ECCA Sandie Keene, President, ADASS Frank Ursell, Chief Executive, Registered Nursing Homes Association Louise Crook, Partner, Harrison Clark Rickerbys Rhidian Hughes, Head of Social Care, Centre for Workforce Intelligence Jon Chapman, Director, Pinders Healthcare Consultants

Publications

CMM magazine is officially part of the membership entitlement of:

Bruce McKendrick, Chief Executive, Voyage Care Des Kelly OBE, Executive Director, National Care Forum Andrea Sutcliffe, Chief Executive, Social Care Institute for Excellence

ABC certified (Jan 2012 - Dec 2012) Total average net circulation per issue 16,302

Chris Tarry, Consultant, Carterwood Simon Duffy, Director, The Centre for Welfare Reform

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is it just me...?

Is it just me...? Robert Chamberlain, Editor in Chief, gives his thoughts on the cultural barriers that must be addressed to enable true integration of health and social care. The Government has released Integrated Care and Support: Our Shared Commitment with the stated commitment being to develop a joined-up health and social care system by 2018. It makes absolute sense in theory, but how plausible is it to consider such a system ever becoming reality? To me, the greatest challenge to integrating health and social care is overcoming the cultural issues that currently exist and top of the list has to be the budget-driven, decision-making mentality.

and social care began taking place. If the intervention provided by social care services is reduced then obviously more people will become emergency cases and require hospitalisation. The savings from these cutbacks are now costing the NHS dearly and having a terrible impact on the quality of life for older people, in particular. Surely lessons will be learnt from this crisis together with an acknowledgement that social care, as an integrated service with health, is the key to improving public wellbeing and a more efficient use of taxpayers’ money. Or maybe not!

Money-Minded Of course, in these austere times, budgetary implications are bound to have an impact on how care services are delivered. However, budgets seem to be the primary focus, with the needs of the public being secondary. There’s a multitude of departments involved in providing the complete spectrum of care but their funding decisions are made largely in isolation of each other and based upon their own individual financial objectives. The King’s Fund’s call for merged budgets makes absolute sense and would eradicate many of these problems. There also appears to be little foresight of the knock-on effect of Government imposed cutbacks – take the crisis in A&E departments as a prime example. The A&E crisis and pressures on other NHS services may be making the headlines now, but frankly the situation was inevitable once cutbacks to the funding of community

‘Barriers to health and social care institutions working together need to be demolished’ GoinG it alone Take a look at the CMM Business Clinic (pages 26 and 27) and you will see that some hospitals are trialling the Scandinavian concept of ‘health hotels’ as a method of relieving bed-blocking and saving money. Building and staffing these ‘hotels’ with NHS budget rather than engaging with existing social care providers; it hardly echoes the sentiment of integration. It is also questionable whether such a move is in the best interests of patients. Critics have cited concerns over the wellbeing of the ‘hotel’ residents in a

model that relies on relatives to perform a caring role. This family care will potentially be at the expense of employers who, in the Scandinavian system, are forced to grant employees additional paid leave for this purpose. Barriers to health and social care institutions working together need to be demolished and collaborative solutions to improve patient care in the most costeffective way must become the norm. I’m unsure if it is trust issues, poor communication or understanding of each other or the battle to retain budgets, but seeking individual solutions to issues that cross the divide makes little sense. That said, concerns about the potential £1 billion of the NHS’ ring-fenced budget going to councils for social care needs are understandable to a degree. The plans, being drawn up in the Government’s forthcoming spending review, aim to keep more people out of hospital. I do worry how much of this money will find its way to non-social care causes once at local authority level?

encouraGinG noises There are encouraging noises coming from the Government regarding the importance of social care and its role in the future of this country’s healthcare system. Let’s hope that the challenges to integration are not underestimated and all this talk doesn’t become just rhetoric. if you would like to comment please email robert.chamberlain@caremanagementmatters.co.uk

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News

Appointments Appointments

• Corporate • Local authority • Planning News editor - Des Kelly Health and social care to be ‘joined-up’ by 2018 The Government has announced plans for a more joined-up health and social care system by 2018. Joined-up health and community care is not currently the norm, with people often receiving disjointed care and support, not designed to suit their needs. In a recent study, 3% of bereaved people said hospitals did not work well with GPs and other services. Now the biggest ever commitment to making

coordinated health and care a reality has been launched. Key players in the health and care field have published plans that will see them working together to put people first. Integrated Care and Support: our Shared Commitment sets out how local areas can use existing structures like Health and wellbeing Boards to bring together local authorities, the NHs, social care providers,

education, housing services, public health and others to make further steps towards integration. The plans, which will be delivered by national leaders and local areas together, include an ambition to make joined-up and coordinated health and care the norm together with the first ever agreed definition of what people say good integrated care and support looks and feels like, which will be developed by National Voices.

Protecting against care home failure New measures, including financial checks on care providers, are being introduced to protect people receiving care if their provider fails. The first ever system

of national oversight and coordination will give early warnings if a company is in trouble. The CQC will take on the responsibility of a tough system of checks on the

largest care companies – including those that provide domiciliary care as well as care homes. see the Chris Tarry of Carterwood’s article on page 16.

Your Care Rating 2013 survey The deadline is looming for care providers to sign up to Your Care Rating 2013, the satisfaction survey of care home residents designed to promote quality improvement and help those choosing care homes. Operators need to register with Your Care Rating by 10th July to take part in the 2013

survey which will be carried out in september and October, with results to be published in December 2013, enabling current and future residents to make objective comparisons between homes. Your Care Rating has commissioned Ipsos-Mori again to undertake the survey and analyse the

results. The Your Care Rating survey covers care homes of any size in england, scotland, wales and Northern Ireland. The survey will cover homes that primarily serve older people (aged 65+) but younger adults in such care homes will be included. www.yourcarerating.org

new Chief exeCutive for menCAp Mencap has appointed Jan Tregelles, its current Director of Personal Support, to become its new Chief Executive. She has been the Director of Personal Support since 2002 and has grown the business from £80 million turnover to £180 million. new president for AdAss Sandie Keene has taken over as ADASS President from Sarah Pickup. Sandie is Director of Adult Social Services with Leeds City Council, a post held since 2007. See our 60 Second interview with Sandie on page 25. priory Group The Priory Group of Companies has appointed Sian Wicks as Director of Corporate Assurance and Chief Nursing Officer. Sian moves from her current role as Director of Safety, Quality and Compliance. new md At sureCAre SureCare has appointed Gary Farrer as Managing Director. Under his leadership the company is expanding into childcare, respite care and providing home services to carry out a full range of household tasks. four seAsons Dr. Claire Royston (MB ChB MSc FRCPsych), Group Medical Director for Four Seasons Health Care, has been appointed to its Senior Management Team. new ChAmpion for Adult soCiAl work Lyn Romeo has been appointed as Chief Social Worker for Adults by Minister for Care and Support, Norman Lamb. The new Chief Social Worker for Adults will help to improve the quality of care across adult services and act as a champion for those who receive services and the professionals who work in the sector.

Care is all we do. www.castleoak.co.uk

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news / in focus

Guidance on people who challenge services skills for Care and the National Development Team for Inclusion have published new guidance for employers designed to support staff working with people who challenge services. This innovative partnership has produced guidance focusing on what organisations need to do to support their staff, building workforce skills and knowledge, how to use learning tools and resources and identifying

training solutions for teams. The guidance is aimed at employers and commissioners working with people with a range of care and support needs including older people with conditions across the dementia spectrum, people with mental health and personality conditions and those with learning disabilities with complex needs who may have been labelled as ‘challenging services’.

National survey of Personal Budgets A survey of more than 3,300 people who use personal budgets in social care and their carers has found positive results. The survey found that over 70% of people who hold a personal budget reported a positive impact on being independent, getting the

support they need and want and being supported with dignity. In addition, over 60% reported a positive impact on physical health, mental wellbeing and control over support. The survey found only small numbers of people reporting any negative impact.

First year of Dementia Challenge The Dementia Challenge champion groups have produced a report on their progress since the challenge was launched in March 2012. The report describes achievements in the three main areas of the challenge: driving improvements in health

and care, creating dementiafriendly communities and better research. The report also identifies shared themes across the work of the three champion groups, reflects on what they have learnt so far and sets out how they will work together to sustain and accelerate progress.

supervision in social care A new online guide and two new social Care TV films have been launched by the social Care Institute for excellence (sCIe). sCIe says that supervision works best when it occurs regularly, is based on a respectful relationship and is embedded in an organisation’s culture. Good supervision can improve people’s quality of life, and that training is important

to support good supervisors. The films show how effective supervision can improve the quality of care and outcomes for people, and how staff development can be enhanced. The new guide includes recommendations for different care staff; information on how people who use services can contribute; and practical help and guidance.

In Focus: Government publishes Care Bill What’s the story?

The Care Bill introduces legislation to provide protection and support to the people who need it most. The official description of this important legislation was highlighted in the recent Queen’s speech: ‘A Bill to reform the law relating to care and support for adults and the law relating to support for carers, to make provision about safeguarding adults from abuse or neglect, to make provision about care standards, to establish and make provision about Health education england, to establish and make provision about the Health Research Authority, and for connected purposes.’ In addition the Bill will take forward elements of the Government’s initial response to the Francis Inquiry.

hoW is the Care Bill struCtured?

The Bill is split into three parts: Reform of care and support The Bill brings together existing care and support legislation into a new, modern set of laws and builds the system around people’s wellbeing, needs and goals. It sets out new rights for carers, emphasises the need to prevent and reduce care and support needs, and introduces a national eligibility threshold for care and support. It introduces a cap on the costs that people will have to pay for care and sets out a universal deferred payment scheme. Response to the Francis Inquiry on failings at MidStaffordshire Hospital The Report of the Mid-staffordshire NHs Foundation Trust Public Inquiry led by Robert Francis QC, identified failures across the health and care system that must never happen again. This Bill helps deliver the Government’s commitment to ensure patients are the first and foremost consideration of the system and everyone who works in it. It sets out Ofsted-style ratings for hospitals and care homes so that patients and the public can compare organisations or services in a fair and balanced way and make informed choices about where to go. Health Education England and the Health Research Authority The Bill establishes Health education england (Hee) and the Health Research Authority (HRA) as statutory non-departmental public bodies, giving them the impartiality and stability they need to carry out their roles in improving education and training for healthcare professionals, and protecting the interests of people in health and social care research.

What happens next?

The Care Bill is being introduced following extensive consultation with people and organisations right across health and care – from users of services to providers of care. The Department of Health (DH) has produced the Care Bill Explained to describe the changes that have been made in response to the public consultation and the recommendations of the Joint Committee that carried out prelegislative scrutiny on the Draft Care and support Bill. The DH has also publised a series of helpful factsheets covering aspects such as the funding reforms, market overview and quality ratings which provide a summary of the details. The Care Bill is expected (subject to the parliamentary process) to achieve Royal Assent in early 2014.

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property news

Colliers sells Homebridge Manor Colliers International’s Healthcare and Residential teams has completed the sale of Homebridge Manor in witham, essex to residential developers Kingscastle, on behalf of administrators, Baker Tilly. Colliers International sought an asking price of £800,000 for the property, which

comprises 23 fully-equipped assisted living apartments. The buyer has plans to convert the

existing building to provide a number of private flats, subject to planning.

sale by DC Care DC Care has successfully sold Didsbury Court Rest Home in Torquay. The confidential sale saw the home sold to Ark Care Homes Limited of Bideford, North Devon. Andy sandel and the team at DC Care handled the negotiations.

Valley Lodge Care Home acquired Local healthcare operator Karim Rajan has completed on the acquisition of Valley Lodge Care Home, with funding (loan facilities) from The Royal Bank of scotland (RBs). Based in Chandlers

Ford, Hampshire, Valley Lodge Care Home currently provides accommodation and personal care for 30 individuals. The home specialises in offering facilities for those living with dementia.

Following the recent acquisition Mr Rajan also has plans to increase the facilities at the home by extending the existing property to accommodate 43 individuals as well as undertaking a full refurbishment.

Choice’s new service specialist care provider Choice Care Group is continuing to expand into Oxfordshire with the opening of a new service in Didcot. The property, Meylan, in

Didcot, consists of six en-suite rooms in the main building and a separate, self-contained, one-bed annexe at the bottom of the garden. Meylan will support individuals

with learning disabilities and complex behavioural needs, including autism. It will be staffed on a 24-hour basis and will offer in-house psychological support as well as a

commitment to on-going education and personal development through structured activity programmes, both within the home and the local community.

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property news

Intermediate care in Leeds Construction and property solutions firm strategic Team Group has completed the £1.3 million redevelopment of a former residential care home in Leeds, to become the city’s first intermediate care unit, providing 40 community intermediate care beds. The south Leeds Independence Centre is jointly commissioned by Leeds City Council and NHs Leeds south and east CCG, with Leeds Community Healthcare NHs

Trust as the lead provider. The centre, which has been extensively refurbished, will provide person-centred care, focused on rehabilitation and promoting independence.

sanctuary’s new site sanctuary Group has acquired a site in Hersden, near Canterbury in Kent, with a view to operating a new 60-bed care home. The transaction was brokered by specialist property adviser Christie + Co on behalf of Frontier estates. Planning consent has been granted for the new 60-bed care home, which sanctuary Group wants to build to serve the local community. The finished building will deliver a high quality, state-of-the-art care

home and will create in the order of 50 new jobs. Construction is due to start later in the year.

Cardiff care home redevelopment Cardiff-headquartered Linc Care, the health and social care division of housing association Linc Cymru has completed the first phase of its £4.7m redevelopment of Penylan House Nursing Home in Cardiff and the first residents have moved in. Penylan House

is Linc Care’s second purposebuilt community nursing home. when complete, Penylan House will have 73 en-suite bedrooms, assisted bathrooms, spacious lounges, dining areas, solar panels to generate electricity and landscaped gardens.

Construction has been split into two phases to ensure that residents didn’t need to move offsite during the redevelopment. The existing 28 residents have now moved across from the old building to the newly completed first phase which

consists of 30 bedrooms. work is currently underway on phase two and the vacated existing building is being prepared for demolition. This phase consists of a further 43 bedrooms and is due to be completed in June next year.

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local authority & planning news

Longcross’ care home project

Manchester dementia development North west-based chartered surveyor, Jones Melling, has been appointed by Capstone Care, to oversee the construction of a £3 million care home in Bury, Greater Manchester. The 53bed facility, which will offer 24-hour dementia services,

Longcross has won the £6.5 million contract to construct the Moore Place Care Home in esher. with work due to start shortly, the project will span over a 60-week period with completion expected in July 2014. The design and build scheme for Anchor Trust

will be linked to the existing residential facility at walshaw Hall. Built in 1854, the Victorian building currently provides residential care for up to 50 residents. Plans for the new three-storey building were approved by Bury Council in February.

Portsmouth extra care work has started on a stateof-the-art development for older people in Portsmouth. The Maritime House development, with 80 flats, is being built on the site of the former 50-bed Alexandra

somerset home plans 120 new jobs could be created with the proposed building of a new care home in Bridgwater. One of somerset’s largest care providers, N Notaro Homes Ltd has submitted a planning application to build on the corner of Bower Lane, Bridgwater. If approved, work on the 88 bed dementia

nursing home including 24 assisted living units could start as soon as late summer 2013. The home will provide specialist care for older people living with dementia and younger adults with learning disabilities and will help to meet the growing need in the local area.

with two new homes ‘designed to meet the needs of residents with specialist needs’. It also proposed to develop a community village for older people.

New extra care for Housing 21 and Balfour Beatty work has stared on a new extra care development in Derby. The construction is being undertaken by Mansell, a brand of the Balfour Beatty Group and the development is in conjunction with Housing 21 and Derby City Council. Beaumont walk will include 70 two-bed apartments and a community hub with launderette, shop,

restaurant and hair and beauty salon. 24-hour onsite care will also be available and the development has been designed to incorporate environmental and sustainable elements to give the site a ‘very good’ green’ rating. Internal and external design will also add interest and create tranquil settings for residents.

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York’s modernisation plans City of York Council has agreed a modernisation programme to replace the council’s existing care homes that are no longer ‘fit for purpose’ and replacing them

and Moore Place Holdings LLP is a 60-bedroom care home over five floors, including a lower ground floor and accommodation in the roof space. The project includes landscaping and car parking for the care home and neighbouring golf course.

work has commenced on a new £750,000 specialist care home facility in Bradford which will create 20 local jobs. Yorkshirebased Horizon Healthcare Homes has secured funding from the The Royal Bank of scotland to construct the new home which

will be named Beckside Lodge. Horizon Healthcare Homes specialise in building new build homes offering care for adults with learning difficulties who may also suffer from physical disability or sensory impairment. It is expected to open in October.

Outlook Care opening Outlook Care has opened its new dementia nursing home in essex. As well as providing nursing care and specialist dementia support, Foxburrow

Grange also offers assisted bathing and pampering at its in-house spa, rehabilitation following a stay in hospital and short respite breaks.

Hare Hill extra care Permission has been granted for the first extra care scheme in Littleborough, built by mutual housing provider RBH. work will start later this year to be completed in 2015. The development has been designed with input from RBH’s residents, the local community and in conjunction

with Rotherham Metropolitan Borough Council’s social Care team. The scheme, which has been designed by Pozzoni architects, is set to provide a welcoming place where residents will find privacy, support, comfort and companionship; a building they are proud to call home.

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corporate news

Maria Mallaband funding deal Yorkshire care group on The first transaction will Maria Mallaband Care Group expansion drive see the creation of a new (MMCG) and Apache Capital Partners, the London and Bahrain based real estate investment management firm announced a £50 million care home funding deal, as part of Apache’s growing social Infrastructure investment platform which in operates with Joint Venture Partner Tadhamon Capital. The funding will enable the development of up to eight luxury 5 star care homes under the MMCG brand.

£6.7 million 53-bed care home in Gerrards Cross, Buckinghamshire. The high specification premium care home will offer luxury en-suite bedrooms, spacious reception rooms, residents and visitors’ café, cinema room, hair dressing salon and library. The home situated on Oxford Road will cater for all categories of care including, dementia, nursing and residential and will boast the decor of a 5 star hotel.

Bradford- based Czajka Community Care services, which is part of Czajka Care Group, has created 23 new jobs in Kirklees after expanding its operations into the area and opening an office in Huddersfield. The company has also won a contract with Kirklees Council to provide a wide range of home support services, including dressing, bathing, medication administration, domestic duties,

health monitoring, night care and emergency cover, across the Colne Valley. The new roles include a registered manager, care co-ordinators, senior carers and home support workers who will be based from the company’s new office at The Beehive at Longwood and these latest appointments take the company’s total workforce to more than 550.

Vida Healthcare expansion Two new specialist dementia care homes are being planned by a North Yorkshire business following the success of its first £5m venture, launched with support from Yorkshire Bank. The two new homes, both for the Yorkshire region, are currently at the planning

phase for Harrogate-based Vida Healthcare. Vida launched its first venture last year with financial backing from Yorkshire Bank’s Business and Private Banking Centre in York. News of the proposed homes by Vida Healthcare, run by father-and-son team, Chris

and James Rycroft, is part of a strategy to create five homes with a total of 500 places. Last year the company opened the 70-bed Vida Hall, starbeck, Harrogate, which created 70 new jobs. Vida Healthcare’s approach includes providing specialist care, which enables residents to reduce their

dependency on antipsychotic medication. The care home operator works closely with a leading clinical psychologist, specialising in cognitive stimulation therapy, to pioneer a new treatment for mild dementia, which reduces anxiety and drug dependency.

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corporate news

HomeCall Independent Living partnership HomeCall Independent Living, which is part of Coast & Country, has announced the launch of a new partnership with leading homecare provider Heritage Healthcare as it further improves its independent living support services. The announcement follows HomeCall Independent Living winning a contract from Redcar and Cleveland Council to supply Telecare services to older and vulnerable people across the region. The introduction of further

services has created extra jobs, as staff are now responding to alerts triggered by HomeCall assistive technology that has been installed in people’s homes. HomeCall Telecare monitors signs of potential problems and emergencies that may affect people living safely and independently in their own homes. These are linked to HomeCall’s customer contact centre, where advisers then respond to each individual situation.

20th anniversary for regis: ctv National care training provider regis: ctv is celebrating its 20th anniversary. A leading provider of specialist national learning resources for the health and social care industry, regis: ctv has been

supporting the care industry since June 1993 and constantly develop new resources. Recent restructuring sees David Cousens as Chief executive and Pauline Misselbrook as Managing Director.

Caremark wins contract to deliver care for Anchor Caremark (Redcar and Cleveland) has won a new extra care contract to deliver 24-hour care on behalf of Anchor. The extra care developments in Cleveland are owned and run

by Anchor in partnership with Redcar and Cleveland Borough Council. staff currently working for Anchorwill transfer over under TUPe regulations.

Mixed views on NHs reforms GPs and healthcare professionals attending Health+Care still haven’t made up their minds on effectiveness of NHs reforms. 56.6% of respondents believed we should either continue with the current

system or were unsure on what action to take, but 43.4% said the Government should turn back the clock on the Health and social Care Bill. Over 52% believe GPs shouldn’t be responsible for standards of

care in hospitals. Only 15.8% believe that co-payment won’t be introduced the next decade. worryingly 62% don’t believe the NHs will provide them good care in old age. 42% nominated Andy

Burnham MP as the most effective future Health secretary. Only 12.4% endorsed Jeremy Hunt MP, 10.1% endorsed Norman Lamb MP, but more than 34% wanted none of the above.

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Financial oversight of care homes -

WILL IT WORK? At the beginning of May, the Care and Support Minister, Norman Lamb MP, announced that larger care home companies in England are to have their finances scrutinised in a more systematic way, as part of a move to avoid a repeat of the Southern Cross debacle of 2011. This pronouncement was fleshed out in a little more detail in the Department of Health publication Oversight in Adult Social Care – The consultation response May 2013, with legislation promised ‘at the earliest possible opportunity’. Chris Tarry analyses the reality of such proposals.

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here is no doubt that the motive behind the proposed legislation is laudable. The threat of home closure can be devastating to residents who have come to rely on continuity of care and place as part of the bedrock of their remaining years. Families too are likely to suffer uncertainty and distress at the prospect. The industry and the Government got lucky with Southern Cross, in as much as the outcome could have been much worse. Continuity of care was largely maintained; although as time has passed, and here I speak from personal experience, many ex-Southern Cross homes are seeing considerable changes, as new ownership regimes and staffing practices are put in place. The Minister said that, ‘This early warning system will bring reassurance to people in care and will allow action to be taken to ensure care continues if a provider fails’. This begs a number of questions. 1) What is our experience of government oversight of private companies? 2) Who will oversee the process and where will the necessary expertise be drawn from? 3) What criteria will be used to decide what constitutes financial sustainability for a care home organisation? 4) Will the process be made public at any stage? If so on what basis? 5) How will smooth transition be managed should there be a company demise? 6) Is the burden being placed on local authorities too great considering they are already under significant resource pressure? 7) Why is the scheme only being proffered in relation to larger care home organisations?

LESSONS FROM HISTORY The history of government regulation and oversight of private industry is chequered to say the least. In theory our banks and financial institutions were regulated or at least overseen



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financial oversight of care homes – will it work?

by the Bank of England, and we all know what happened there. Long term public disquiet about the ability of organisations like OFCOM and OFGEM to effectively regulate private utility companies is also testimony to the fact that this is no easy task. Couple that with the fact that large property-based care home groups can have complex financial structures, and may not even be owned in the UK, and the scale of the task becomes more apparent.

Choosing the right reguLatory body At present it is intended that new legislation will be put in place to give the Care Quality Commission (CQC) the necessary powers to conduct the appropriate oversight. The CQC currently attempts to regulate the quality of social care. It is not always successful, and is often cited as being under-resourced to do a truly effective job. The new legislation would task the organisation with something even more complex. The structure of large corporates can be complicated, as can their financial systems. Ownership detail may be similarly complex. The task proposed requires highly specialised knowledge, which may be outside of the scope of current CQC abilities. Will specialist staff be brought in and the organisation properly resourced to carry out the function? If an overarching strategy is to unite health and social care then might it not be pertinent to consider the existing NHS financial regulator as both more homogenous in the long term, and certainly more qualified in the short term?

how wiLL finanCiaL sustainabiLity be judged? The financial sustainability of an organisation can often be a matter of timing and access to appropriate liquidity. A 2013 view of financial stability is probably very different to one taken prior to the banking crisis of 2008. Different financial regulators will seek different forms of reassurance, depending on economic climate, particular market sector conditions prevailing at any one time and overarching governmental strategy. What is not clear is what reassurance levels are going to be needed by these proposals. The selection of appropriate criteria could well include or exclude organisations from needing to produce a sustainability plan. Similarly, who will be commissioned with conducting an independent business review, should one be required to manage a risk situation?

ConfidentiaLity a key issue There are arguments for and against strict confidentiality being maintained should a care home company’s finances come under review. It is not difficult to imagine the scaremongering that might take place in relation to any company identified by the regulator as needing to prove its financial worth. The wrong kind of media attention could trigger an exodus of residents fearful of imminent problems, exacerbating an embryonic situation into a full scale crisis. This fear may or may not be justified, but media organisations in search of a story are unlikely to concern themselves with ensuing complications. Even where strict confidentiality is imposed there is always the possibility of a leak. Alternatively the view could be taken that residents and families should be fully informed throughout any such review process. The media management of any such situation is clearly of considerable importance.

is smooth transition aLways possibLe? The collapse of Southern Cross might have been much more

damaging to the care home industry, residents and staff, if it hadn’t been for the willingness of operators within the sector to step in and take over the running of the portfolio. This same willingness may not be present at a future date. The Department of Health said in its consultation process that the Southern Cross result was not a foregone conclusion. What is the Government’s proposal where ownership and, consequently, continuity of care cannot be seamlessly transferred? At present the position seems to be that the Government is not in the business of bailing out private companies; however, in the past, some industries have been considered too important to be allowed to fail, and public money has been used to shore up private institutions. A dangerous precedent, but one which was set with some speed and on a breath-taking scale when it came to the rescue of the banks. Is care of the elderly and vulnerable in our society any less important? The Government needs to provide guidance as to exactly what it will and won’t do in respect of a major collapse, rather than wait to be led by unfolding events.

is the burden on LoCaL authorities too great? Local authority finances are being squeezed hard. Social care, along with all other departments, is feeling the strain; it is not immune. The proposed legislation will place a clear duty on local authorities to meet the needs for the temporary care and support of any person, whether state or self-funded and whether in receipt of residential or non-residential care, if they have urgent, unmet needs as a result of provider failure. Will appropriate funding be provided to facilitate this process? Will the infrastructure be put in place to cope with placement in extremis? Again the absence of detail makes it difficult to be wholly confident of the outcome in such a situation.

aLL residents are important There has already been comment suggesting that the proposals are unsatisfactory as they only deal with larger care home groups. Is there to be a two-tier system of protection dependent upon the size of the company running a care home? The risks to a resident are the same regardless of operator status. Recent evidence suggests that small scale closures have doubled in the past two years. It seems sensible then to institute some form of financial regulation for small care home providers. Here the CQC may have a role to play, as financial structures may be less complicated, and be within its existing capability. So, are we all reassured by Norman Lamb? Well, we need rather more reassurance than has been provided to date. There’s an old saying that the road to hell is paved with good intentions, but that’s not really accurate: it is those intentions that are not properly thought through, carefully implemented and properly financed that can produce a fast track to disaster. This issue deserves a holistic approach that covers the whole industry, with appropriate resources and expertise being put in place. We may yet be pleasantly surprised, but if we look at the history of government oversight of private companies these proposals may come to look like the triumph of hope over experience. It is up to Norman Lamb and his colleagues to ensure that this doesn’t happen. cmm Chris tarry LLb (hons) dip aa is Consultant at Carterwood, Chartered surveyors and healthcare specialists. chris.tarry@carterwood.co.uk

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lookIng to tHe future Social care is finally rising up the Government’s agenda. However, Government policy set against a backdrop of austerity, rising demographics and a stalled market mean the future is by no means clear. We’ve come a long way in the last ten years so what will the next ten bring? CMM shares the thoughts of some leading sector figures.

InevItable need for effIcIent care delIvery Jon chapman

director

Pinders Healthcare consultants

You realise you’ve been in your job a long time when you realise you’re writing your third ten-year prediction! I’m pleased to say that most of the expectations I set out in the early 1990’s and at the turn of the millennium have come to pass, so what can we expect from the next decade? The inescapable facts are that demand for care will increase significantly (an extra 1.8 million pensioners) and the cost will be too much for the State to bear. This is the elephant standing in the corner of every meeting Norman Lamb and his colleagues hold and it can’t be ignored going forward. Whilst the desire is to provide topquality care for our older population in excellent accommodation, unfortunately that comes at a price we can’t afford. It would be lovely if we could look after the elderly in the familiarity of their own homes but in ten years’ time much of the country will be gridlocked, so even the ten-minute visits of today will be impossible. There will be little time for even the basics of care, let alone the niceties of talking, listening and helping to ease the pain of loneliness. It is inevitable, therefore, that we will need to gather our elderly together to enable more efficient care delivery. The extra-care housing model works well and will certainly expand to provide a safe, secure and sociable environment with the comfort of immediate oncall support as needed. The big challenge though will be to provide such facilities on the scale necessary and to make it affordable for all pockets. Perhaps Mary Portas will suggest town-centre extra-care as a way of rejuvenating our redundant high streets?

Care homes will still have a role to play, but almost certainly in meeting the higher care needs of those with pronounced dementia and/or palliative nursing conditions. None of us know how our body and mind will change in old age, so flexibility will be the key in allowing people to continue living in familiar surroundings whatever happens. Whatever the type of accommodation, it will be far better than we have at present. We already have some excellent housing and homes which will stand the test of time but we also have some horrible, substandard facilities which are unfit for the 21st century. Unfortunately, these are being sustained by cost-cutting councils and it’s another unpleasant truth that quality and choice is only available to those who can afford it. That said, the very worst care homes won’t be around in ten years’ time, as investors turn their back on such substandard stock. There will be fewer, larger care homes although there will still be a place for the exclusive, boutique home catering for the wealthier individual. We can expect to see care-insurance products being more widely available, as the Government’s cap on care costs provides a degree of certainty, but these won’t be paying out until the following decade. In 1990, my personal hope was for a small home, with licensed bar and 9-hole golf course! I still think such an option will exist but I fear neither my handicap nor bank balance will be in sufficient health to enjoy it!

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looking to the future

‘Quality and funding will remain key and constitute an on-going challenge for providers in 2023’ a decade for flexIbIlIty and resPonsIveness bruce mckendrick

chief executive

voyage care

The growth in need for services for those with learning disabilities will continue over the long term driven by factors such as an ageing population and better diagnosis. These statistics will continue to put pressure on capacity issues for councils and providers, but there are other fundamental changes afoot that will result in care provision looking very different in 2023. Driving these changes should be the people who need the support. Not only will they have more control over what they want to do with their lives in 2023, but, more importantly, they will have more control over how money associated with their care and support is invested. This is entirely appropriate.

service, supporting people effectively in their own homes, as well as in more traditional settings.

We have always believed the future of our sector lies in the provision of flexible, personalised care. In order to achieve this, we, and others in the sector, must be increasingly dynamic. We need to work with the people we support to ensure that at any given moment, they are accessing services that are relevant to their needs. We must also be prepared to actively support them when change is required to ensure the best possible outcomes. Being flexible enough to respond to these developments ensures the on-going integrity of our industry. Services should support the individuals they were designed to support.

Quality and funding will remain key and constitute an on-going challenge for providers in 2023. How will we maintain consistently high levels of care against a backdrop of ever depleting local authority funding? Closer, more open relationships between commissioners and providers will go some way to achieving this, as will smarter, more efficient working practices and effective use of technology.

We are already seeing increasing demand for outreach services and by 2023, we would expect this area of the market to have grown even further, as clients start to take more control in determining what their support should look like. There will always be a role for care homes but by the end of the next decade, we believe the strongest providers will be those that have listened to clients and are able to offer a more holistic and personal

Another defining characteristic of the leading providers in 2023 will be their ability to truly personalise care packages. Together with Helen Sanderson Associates, we are already working extensively in this area, utilising tools like personal one page profiles to match likeminded individuals. In ten years’ time, we would hope to be leading a sector where every provider is working collaboratively with the people they support.

By 2023, organisations will no longer be judged on whether they are a private or public sector provider. Instead, they will be judged on their merits and whether they are able to deliver appropriate and high standards of care, at a price that constitutes value for money relative to the quality delivered. Accountable for their actions, 2023’s successful providers will be those who have invested heavily in quality and ensured they make a real difference to people’s lives. They will also be those that have been responsive to the needs of the individuals they support, willing to change and receptive to different ways of delivering care.

dream or nIgHtmare? des kelly obe

executive director

In the year 2023 (which sounds rather like the curious 1969 No1 hit for Zager and Evans which heralded the relentless march of machinery and technology along with the inevitable depersonalisation and the erosion of humanity and religion) it seems likely that there will have been significant changes to the care sector. The NHS will be celebrating its 75th anniversary year reflecting on its achievements, in particular the major step introduced five years previously, of fully integrating care and health services to make them easier for people to access and navigate as well as improve satisfaction and outcomes. It will also have been some seven years since the Government implemented the recommendation of the

national care forum

Dilnot Commission on funding for care and support. Technology will have developed at a pace and much of the benefits of telecare, telehealth and telemedicines are now taken for granted. So what else might we expect? Dare we imagine that care and health provision has been totally transformed through the use of personal budgets and direct payments to fund every type of service and as a consequence commissioning is virtually unrecognisable as it consists entirely of individual relationships? In fact, personal budgets could have been extended across all public services as they have proved so effective and lead to much better outcomes as defined by

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2013 LCS and Adam Smith Institute Health and Social Care Spring & Summer Events May 15, June 4 and July 1. Time: 3.30-5.00pm. Afternoon tea will be served The Cholmondeley Room, House of Lords, Westminster, overlooking the Thames These events will be kindly hosted by Lord Ribeiro CBE, Lord Clement-Jones CBE and Baroness Jolly Organised by LCS International in partnership with the Adam Smith Institute, these are now established as leading annual policy events in the health and social care calendar. They bring together senior people in the private and public sectors and facilitate discussion between the NHS, Social Services and the independent and voluntary sectors on the significant challenges and opportunities in health and social care. They are held against the background of the new Health and Social Care legislation, the Care and Support Bill now before Parliament and anticipated implementation of Dilnot.

On Monday July 1, Baroness Cumberlege will chair a panel of speakers: Baroness Jolly, Rt Hon Stephen Dorrell MP, Liz Kendall MP and Mike Farrar CBE, CEO NHS Confederation. We anticipate discussions on the day around: · Health and Social Care funding issues and reforms · Proposals to enhance Social Care commissioning · New models of integrated care and step down care, including “hospital hotels” that will allow service users to return home in less frail condition. · The Coalition Government’s proposals for rationalising regulations for Care of the Elderly, and persons with learning disabilities and mental illness, following the work of the Law Commission in 2009-2010.

Delegate Price per event : £65 + VAT. To book call LCS on : 0207 387 6828 or email : info@lcsic.com

CMM CAREMANAGEMENTMATTERS

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looking to the future

dream or nIgHtmare? des kelly obe

executive director

the individual. The commissioning process fully complements the seamless provision of services in which funding truly follows the individual. The budgets that support both care and health services have been aligned between local authorities and the NHS, managed by a system of integrated of leadership and management across the former silos of care and health. Many commentators have expressed wonderment at the fact that it took so long to take the step of bringing the services together and to recognise that what used to be called ‘social care’ had the capacity to teach so much to health professionals about making services more personalised and the benefit of underpinning everything with a strong value base to ensure that choice and control really does empower people. The Care Quality Commission has been operating as a combined independent regulator across the full spectrum of care and health for more than ten years and has gained

national care forum

respect for the professional way it operates. The most remarkable change has been the fact that bringing care and health services together has had the following twin effects: • The public finally understands the purpose of care and support and how it relates to health provision which, in turn, has resulted in positive public recognition for the value of services • Working in frontline care has become a career of choice for many younger people as it now has a clear professional career pathway in which learning and development are strong features. On the basis that major reform and restructuring comes around every ten years or so politicians are beginning to trail the idea that new legislation is necessary to control rising expectations and demands on services! Of course there will be at least two general elections before 2023…wake up I’m only dreaming!

toPPIng uP tHe glass for 2023 andrea sutcliffe

chief executive

Prince Charles, Olivia Newton-John, Andrew Lloyd-Webber, Ozzy Osbourne, Terry Pratchett. They are all set to be celebrating their 75th birthday in 2023 - the new kids/older people on the block. A different generation, who will be expecting to have choice and control and so will anyone else who needs care and support in ten years’ time. I spoke about this at the National Care Forum conference in May. I reflected on the coming demographic pressures, as thankfully younger people with a disability are living longer and the numbers of older people will rise faster than the overall population increase. We are likely to see a change in the types of care that people will need and want. For instance, given different, more dispersed family structures, the need for formal support may increase. And we can only assume that the present call for cost-effectiveness will continue for the next ten years. However, things can sometimes move quickly. In January, I wrote a ‘new year resolutions’ article for the Guardian, where I hoped that the talk about integrated services moved from rhetoric to reality, but in a way that is truly meaningful to the people we serve. With recent positive announcements from cross-party politicians and a Care Bill being scrutinised that hopes to enshrine this principle, that is a satisfying few months’ work! The future gives us a great opportunity to exploit technology. Imagine what new advances there will be by 2023. The mind boggles, but we must remember to use it to support people who use services. A recent survey for our Get Connected programme concluded that only 10% of care staff are supporting people who use services to use

social care Institute for excellence the internet for social activities, which in turn can help them to have an improved quality of life. Yes, it is important for service providers to use computers for admin tasks, but it is also vital that we are using the full set of tools at our disposal for the people we serve. But some things will not, and should not, change. There will still be the need for care and support services that are safe, effective and enable people to have a good quality of life. Day in and day out in 2013, people are working hard in difficult circumstances to provide care and support for children, young people and adults, that is compassionate, respectful and caring. May that also be the case in 2023. So how can we prepare for the future, especially when we often feel like we are ‘fire-fighting’ here in 2013? One area is co-production. That sounds like we are building a car together but, despite its clunky technical term (we would love ideas on a new one), it means involving people who use services, and carers, in the design and development of those services. At SCIE, we will continue to develop the evidence-base and share evidence of best practice so we can all learn from innovation and what works well. And we must not forget to support the development of a confident, competent and flexible workforce and leadership. The managers of 2023 are there to be nurtured now. We may all shudder to think ahead ten years. But we have to do it, and it is a really interesting challenge. Tough economic times, yes, but look at the progress we can make. So, I am very much ‘glass half full’ here in 2013. Let us start topping that glass up for 2023. cmm

what do you think? where do you see, or hope to see our sector in 2023? please let us know editor@caremanagementmatters.co.uk.

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Focus on Leadership in the Front Line: The Front Line Leaders Programme Welcome to the National Skills Academy for Social Careâ&#x20AC;&#x2122;s Leadership Section The Skills Academy recently commissioned Insight Management Solutions to design and pilot a programme aimed at Front Line leaders aligned to the Leadership Quality Framework (LQF) and CQC Essential Standards of Quality and Safety. The programme is aimed at staff working in supervisory or team leader roles who would like to understand what it means to be a Front Line leader in the diverse care and support settings that make up the Adult Social Care sector. Participation in this programme enables learners to develop the skills , behaviours and confidence required to fulfil their role and use positive leadership behaviours to develop and maintain high quality services. Each module focuses on the key skills and behaviour required for the successful delivery of high quality services. The programme offers the opportunity for participants to take part in a number of diagnostic exercises. These include a 360 degree instrument, a Mental Toughness Questionnaire (MTQ48) and Belbin team role analysis. There is also the opportunity for participants to achieve an ILM level 4 award. As part of the programme the leaders who wish to pursue the ILM level 4 are able to submit their portfolio which will demonstrate that they have met the criteria.

Maureen Hinds, Head of Programmes at the National Skills Academy fo Social Care, shows how investing in Front Line staff can pay dividends in terms of leadership.

We are currently running two pilots, with 24 participants overall - one with Avante Partnership, a large social care provider in the South East which started in October. The other pilot is an open access programme with leaders from a selection of private, voluntary sector local authority employers who are located across England, which started in January. Across the two pilots we have twenty four front-line leaders who all seem really keen and engaged with this blended learning programme which included using online learning and other technologies. The pilot programmes were heavily subsidised and offered to Academy members at a heavily subsidised price as part of their member benefits. I am equally impressed by the impact the pilot is having with the leaders, those who have participated have said through the evaluation forms that they have been given the freedom to engage in group activities, learn to network with other candidates, it has increased confidence, helped them to develop their leadership abilities, and discuss some were very interesting topics. Weâ&#x20AC;&#x2122;ve asked some of them to talk in more detail about the impact on themselves, their service users and their organisations. You can read more about this overleaf.

If you would like to find out more about the launch of the full programme, please contact leadership@nsasocialcare.co.uk

Front Line Leaders Terry Linehan and Laura Dennis, Programme Tutors When the National Skills Academy decided to launch a new development programme for Front Line Leaders in Social Care, we at Insight were delighted to be asked to design and pilot the programme. The programme is derived from the excellent Leadership Qualities Framework published by the NSA last year. The Framework makes the case for the development of leaders at all levels within Social Care. It also signposts the kinds of behaviours that leaders can use to make them truly effective within their role. The Front Line Leaders Programme is a crucial foundation for leadership in Social Care. It is Front Line Leaders who interact most with service users and they also have the most immediate overview of the way staff meet the needs of service users. If you want to drive up standards of care, you need to start with Front Line Leaders! We now have two pilot programmes well underway, with twenty-four Front Line Leaders, from all over the country, who are a real joy to work with! They are all passionate about what they do, but have a wonderfully down to earth attitude founded on considerable experience. All of them are motivated and determined to achieve the highest possible standards, and recognise their role as Front Line Leaders in making this happen. The programme was approached with great excitement and quite a lot of terror as well, partially due to the use of technology in the programme, and partially because this is the first time that Front Line Leaders have been brought together to develop as a management group. The methods used in

the programme blend approaches to learning and include: two-day workshops, personal study and Virtual Classroom sessions held via the internet. All of the sessions are high energy and designed to set people thinking about what they do – and could do – in their workplace. In one of the virtual classroom discussions we focused on ‘Monkey Management’ an approach to empower staff to take ownership for solving problems and reduce upward delegation. Front Line Leaders have really embraced this management tool and have all used it (with great success) back in their own workplaces. Optional assignments give Front Line Leaders the opportunity to achieve the ILM Level 4 Award in Leadership, so current groups are developing their portfolios and busily working on their two assignments. They also receive a completion certificate from the National Skills Academy. It seems clear, even at this stage, that the pilots will be a great success. The next step will be to roll out the programme on a regional basis, to add to the growing network of confident and skilled Front Line Leaders who can champion on-going change in social care. Adult Social Care has long needed a benchmark for the development of Front Line Leaders. We believe that benchmark now exists – The National Skills Academy – Front Line Leaders Programme!

Front Line Leaders Programme Edith Nortje, Langton Care Ltd My Director and Care Manager originally suggested that I go on the programme. I hadn’t realised that it was in London so I was really anxious as I was out of my comfort zone in unfamiliar surroundings. On completing the first day I was really impressed with the course content and the tools provided by the highly competent facilitators, Terry and Laura as I had previously completed a level 3 management course and it was not as good as the Front Line Leaders programme. The highlight of the programme for me was understanding how to manage my time and I have embraced the ‘Monkey’ philosophy, including taking this back to the organisation and printing it off to share with my Manager and my colleagues. We have all adopted this philosophy and implemented into our way of working. The best part of the programme is that as a group, we have come to realise that we all have the same issues regarding staff and time. We all share the same problems but it is good to know that you are not alone ‘we are all in the

same boat’. It is not just me and it is not the way that we manage, it is across the industry as a whole. As part of the programme we had a 360 degree Assessment, MTQ48 and a Belbin Analysis. What was really surprising is that all three showed the same areas of development needed, the way that I perceived myself is exactly the way others saw me. This was clear to see when looking at my character profile. I am working on these areas and will continue to improve on them. The programme was very challenging as it forced us to work outside of our comfort zones and enhance our skills, but it has been fun. Terry & Laura (facilitators) have been wonderful, excellent. The materials and the venue have been amazing. All this has helped to make the programme fantastic. If I had to give an overall score it would five out of five. I would 100% recommend that others take up the opportunity to be part of this programme.

Front Line Leaders Programme Sue Smedley, Avante Partnership

My senior management team asked me if I wanted to go on the programme. I had previously done a Dementia Level 3 and I was available to attend. I come from a rather large care provider and although our pilot consisted of colleagues all from my organisation, there were a number of people in the organisation that I didn’t know. So it gave us a chance to meet and get to know each other, there were colleagues from community support and other areas of the organisation who would not necessarily have met as we are based in different locations. The 360 Assessment was a real challenge for me as I was relying on others to provide feedback and it’s not their priority. So I had to ensure that I got constructive feedback and what I need to complete the 360. Tackling delegation and how to manage this has been a real learning curve for me. By delegating I am able to see the bigger picture and look at the long term view. Although this takes up more time initially to do this, it is crucial that I devote time to this as in the long run it is better for me and the organisation.

The highlight of the programme has been Terry and Laura, who have made the programme interesting and have really supported us throughout the programme. They are always willing to help and it is good to know that I can always contact one of them to help me if I am stuck or need some advice. The virtual classroom sessions have proved to be really good and keep me on track, giving more flow to the course and gives me a chance to catch up with the others, and we can always ‘brainstorm’ with Terry and Laura to iron out any problems that we may be having. The virtual classroom has also been a new learning tool for us. Terry and Laura have made the workshops really interactive, sometimes we have had to juggle or put a puzzle together. We have not always been sure why we have had to do this but it all becomes clear - everything they do is tied together. In these cases it has been about delegating or about having sight of the big picture and what this means for you as a Front Line Leader. Whoever devised this course is brilliant!

Front Line Leaders Programme Chilie Sibelo, Pembroke Care Group I applied for the Front Line Leaders Programme because, as Front Line staff, we are the front door of the house with no key and no handle, just a swinging door. It was wonderful to have a programme that I identified with and provides a foundation to a social care profession. It is a recognised profession so it should have a recognised qualification to support and underpin it. As Front Line staff, I often feel like a member of the armed forces who has been sent off to battle with none of the right equipment. By being on this programme, I hoped that I would be able to support the staff going up the ranks, work together as a team being able to compare notes and network with other Front Line leaders. The first day of the programme I felt really welcomed and speaking to colleagues on the virtual classroom made it so much easier to bond as a group. It has been a really great group of colleagues that are on the programme and I have been really fortunate to be able to be part of both of the pilots. As I am based in Hove it has provided me with the opportunity to network, support and share ideas around how our individual organisations work. The programme has been fun, informative and I can’t believe it is almost over. The programme has made me think about moving forward, I feel that it bridges the gap between top management and

frontline leaders as it offers Front Line staff the ability to implement and put in to practise a number of useful skills and tools to assist them with their job. It has been really challenging for me as I work for a privately owned care home, so some of the tools and skills that I have learnt are harder to implement because I am not in a larger organisation. I still try to get other staff to buy in to what I am doing. My key success so far has been implementing the ‘Monkey’, we pick up the Monkey on entering the office, we feed the Monkey, we pass it on to other colleagues and then we leave the Monkey at the door before we go home. I have also been able to think more about the amount of time I give to supervision and the balance between the time for my own work. My other challenge area has been delegation, as a frontline leader we have always done everything as it is in our nature. Now I think about breaking down the job and delegating key tasks as its about how to get to the end goal. I would recommend this programme to everyone. It should be a nationalised course, open to everyone and when I go back to Hove I would be happy to champion this programme. I have gained confidence and my self-esteem has grown because of the programme and the fact that I am working towards my ILM qualification.

A Fresh Approach to Providing Good Care Derek Lindars, Director of Human Resources, Avante Partnership Avante Partnership is pleased to have had the opportunity to participate in the National Skills Academy Front Line Leaders Pilot Programme. The programme delivers a nationally-recognised qualification and the feedback we received from our participating staff is that they found the programme challenging and thought-provoking while at the same time motivating participants to develop their leadership skills and behaviours. For those working on the Front Line in supervisory roles, this innovative programme builds on the skills and knowledge gained through other training and qualifications so they are able to raise standards, communicate effectively, and work with fairness and consistency. Moving from task-orientated supervision to leadership is a difficult transition. Supervisors invariably excel at their work and while technical excellence serves as a foundation, it is not sufficient to engage others and focus work. Developing leadership skills is challenging and we found the Front Line Leadership Programme was designed specifically to help participants make this significant transition.

Over a period of three months, the three modules titled: ‘managing myself’; ‘working with colleagues’; and ‘working with clients’, were delivered utilising blended learning approaches in a creative way. The modules included a range of learning activities which accommodated participants’ learning styles, development needs and workplace situations and each module included assessment activities that encouraged participants to reflect on and demonstrate their learning. From my perspective, the role of the Team Leader, or supervisor, is one of the numerous social care roles that that is key to the delivery of high standards of service delivery and positive outcomes for those who use our services. The Team Leader role is a challenging role because it is the interface between staff and management. Therefore, it is critical that Team Leaders are developed so they can lead their teams effectively to maintain and foster the trust and support of their teams. My experience is that the Front Line Leaders programme develops the right leadership skills and behaviours for those working alongside staff to deliver great services.

This programme for Front Line Leaders in Adult Social Care will explore key values and behaviours, and help to build leadership confidence The content of this innovative development programme is mapped to the National Skills Academy’s Leadership Qualities Framework, CQC Essential Standards of Quality and Safety and the Skills for Care Manager Induction Standards which means it is really relevant to managers in the Adult Social Care sector. In addition, learners who successfully complete all elements of the programme will be eligible for the Institute of Leadership & Management (ILM) Level 4 Award in Leadership.

This programme is suitable for people who: • Supervise others • Are new to management or about to become a manager for the first time • Work directly with service users in Adult Social Care • Want to improve their leadership skills and confidence • Want to get more from the people they manage, for the benefit of people who use services The National roll out of the Front Line Leaders Programme will take place in September, in London. To register your interest in the programme, please contact leadership@nsasocialcare.co.uk or to find out more about the programme please call 0207 268 3082.

Coming soon from the Skills Academy: new local networks for Registered Managers Did you know there is funding now available for you to set up your own local Network for Registered Managers, or to strengthen a network that’s already running? It’s an ideal way to connect with people and share good practice. For more information, go to www.nsasocialcare.co.uk or email Terri.myers@nsasocialcare.co.uk.

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K E E N E

It s a very busy year. I have ﬁve main priorities. 1. Personalisation and continuing to develop and implement choice, control and independence reforms. 2. Prevention and the understanding that people are assets and not deﬁcits. Building communities and retaining independence through the strength of individuals to prevent long-term intensive support. 3. Integration with the health service.

4. New legislation. 5. Quality and transparency in dignity, compassion and safeguarding. Building relationships with the sector. Wherever you work in the sector, it s a shared endeavour to make an impact to people s lives.

WHAT CHALLENGES DO YOU HAVE TO ADDRESS? Challenges have to include continuing to deliver improvements in a challenging environment; especially with the ﬁnancial challenges and economic climate. There is also a leadership challenge. Championing quality and culture change plus the way the sector works with the public. It s about mutual respect, reciprocity and understanding. It s not a one-size-ﬁts-all approach. It s co-produced and an equal relationship.

FINALLY, IF YOU ACTUALLY GET ANY, HOW DO YOU SPEND YOUR FREE TIME? I m currently split between Leeds, Sheﬃeld, where I live, and London. When I do pass through Sheﬃeld at the weekends, I like to spend time with my family and good friends. I like entertaining and being with people. I also enjoy getting out into the countryside. CMM JULY 2013 ¦ 25

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business clinic

HealtH Hotels – a role for care Homes?

When Lord Howe announced that NHS England should review the use of ‘Health Hotels’ to avoid bedblocking, it wasn’t a new idea. But why use hotels? Couldn’t care homes take on this role as a stop gap for older people returning home from hospital, plus help to drive the integration of health and social care? To the mainstream news the suggestion that NHS England was to review the use of health hotels came as a surprise, but for many in health and care it probably isn’t news. In answer to the over-stretched resources of the NHS, bed-blocking by people with long-term conditions, those with dementia and older people there is talk of exploring a common trend in Scandinavia to place those with lower needs in hotels (on- or off-site). The model could offer those with lower level needs, support and accommodation overnight when not requiring treatment, in cheaper but well-appointed surroundings, with on-call staffing 24 hours a day. This, in theory, could free up costly acute beds whilst looking for the right support for those moving into the hotels temporarily.

Existing schEmEs University College London Hospitals NHS Foundation Trust (UCLH) opened its first health hotel in September 2012. The fourstar boutique hotel, the first of its kind in the NHS, offers a warm, personalised service normally found in good quality hotels but also provides touches of luxury to help patients retain their independence while undergoing clinical tests and treatments. Before opening this bespoke 35-bed hotel, UCLH was the pioneer of this type of care allowing cancer patients to stay in a nearby hotel, free of charge, instead of in the hospital which is reported to be around three times more expensive. Predominantly for cancer patients, the use of hotels offered patients who needed

daily treatment but not 24-hour acute care, an opportunity to reside close to the hospital at a reduced cost to the NHS. Patient rooms have alarm call systems, are briefed on warning signs of complications and must be fit to be discharged. Although it is billed as a cheaper alternative to acute care, it has been reported that the hospital leaves a certain number of beds available should patients require readmission overnight. Many have questioned whether this is, in fact, saving money or an additional cost if the hospital bed is still empty on the off chance it may be required. At the end of May 2013, Lancashire Teaching Hospitals NHS Foundation Trust completed work on a new hotel to provide overnight accommodation for patients and their families. The facility has been developed to meet the needs of patients who require

Makes sense to use care settings

Overlooks the obvious

Louise Crook Partner Harrison Clark Rickerbys

Frank Ursell Chief Executive Registered Nursing Homes Association

Last month, Norman Lamb spoke about integrating health and social care and making them joined-up and co-ordinated. This is a lofty ambition which will require much more targeted funding for social care to pick up those gaps that the NHS cannot and some would argue should not, fill. 2010 figures indicate that a night in a hospital bed costs £300 whereas for half that price, a patient in recovery could occupy a hotel room with a lesser care requirement. Whilst health hotels might be suitable for carers or families, where there is a nursing requirement, it would be make sense to utilise existing care and nursing settings. In Gloucestershire, there are roughly 300 social care vacancies. These could be filled by patients being discharged from hospital. An initiative in Gloucestershire already exists for interim bed placements brought about by joint working between the local authority, NHS and local care association. Care associations are crucial in linking all parties in

this way. In Gloucestershire, care providers sign up to provide two weeks of care to those that require discharge from hospital, after those two weeks a decision is then made for the patient’s future care Similarly, where someone doesn’t need residential care an initiative for providing domiciliary care is available. Some teething problems are inevitable where partners are working together and whilst social care works round the clock, hospital discharge teams aren’t always available at weekends and so some bed-blocking still takes place. This sort of joint working is already providing solutions to the NHS’ burden. Services are out there that don’t require start-up costs or any major investment in infrastructure. Until Norman Lamb decides how social care funding will look, joined up health and community care needs to become the norm so that people’s care pathway doesn’t become disjointed and local care associations are crucial to achieving this goal.

Two immediate thoughts come to mind, firstly, does the patient fully understand that they are staying in a facility which does not have medical care on site? If it did have health care on site such provision would satisfy the definition of the Health & Social Care Act 2008 Regulated Activities of providing ‘Accommodation for persons who require nursing or personal care‘ and ‘Treatment of disease, disorder or injury’ and require registration with the Care Quality Commission. The second revolves around the financial implications, is this initiative driven by improving the needs of the patient or simply the perceived financial saving in not having to pay the £250 per day cost of a night in a hospital? Would a patient honestly choose a couple of nights in a luxury hotel over having instant access to post-operative health care if needed? But, that is not to say that the principle is wrong, just that it seems to have overlooked the

obvious solution. Care homes in general and nursing homes in particular, are well placed to provide such care, with the added advantage of providing health or social care on site and being in every community, thereby being potentially closer to home and families. There are all sorts of reasons put forward as to why nursing homes should not be ‘health hotels’ but most are spurious and usually are no more than pure prejudice. Nursing homes use the nurses who are trained by the NHS, they provide care to a health care model, they already exist and, significantly, there are more beds in nursing homes that there are in the NHS, and on top of that, they are all registered with the Care Quality Commission. The care home sector has a reputation for responding quickly to demands - the NHS just needs to start talking to nursing home owners. In the words of the vernacular, it’s a ‘no brainer’ - so why hasn’t it happened?

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business clinic

daily treatment but live some distance away and for the families of some of the most unwell patients. Around £800,000 has been invested in the new facility, which has been developed by refurbishing a former accommodation block on the Royal Preston Hospital site. It is free for patients and their families to use.

LEarning from abroad The approach of caring for hospital patients in hotel settings is quite common in Scandinavia where hotel chains run these services on hospital sites. One of the pioneers was University Hospital Lund in Sweden. According to its website, ‘Its patient hotel is an integrated part of the University Hospital in Lund. [Working in partnership with the Swedish hotel chain SAS.] The hotel is designed for patients who do not need to be on a ward and can manage an independent hotel stay. Nurses are on hand 24-hours a day. This particular patient hotel has 108 rooms. Each room is equipped with bathroom, television, telephone and alarm buttons.’

govErnmEnt’s considErations Considerations for a wider use of health

hotels by the Government want to take proposals beyond the care of cancer patients and those who live at a distance and look at the care of the elderly, those with dementia or long-term conditions. People in these categories are traditionally seen as bed-blocking. Once in hospital it can be difficult to arrange the right care and support to move them back out again, although their needs aren’t necessarily best cared for on a ward as they don’t need the high level of expensive care provided by acute care facilities.

a roLE for carE homEs? Like in Lancashire, the Government is considering utilising unused NHS buildings on existing hospital sites, run by hotel companies to deliver health hotels. However, where these buildings are not available it could lead to new developments in conjunction with hotel companies. In many cases they could also be used for on-site relative accommodation as well. With tight budgets and reduced funds, many could argue that making better use of social care, care homes, assisted living and home care would make more

sense than starting afresh. As the cause of bed-blocking is an inability to move people from hospitals and back into the community or via social care, from a cost and capacity point of view, could the care sector be an easy solution? With care home occupancy rates hovering around 90 per cent, according to the 2013 Colliers Care Homes Review, care homes may have space to offer the services that the NHS could be looking to hotels to deliver. Care homes are well-placed to help ease the move from hospital for older people or those with dementia or longterm conditions. They already do this to a certain extent with re-ablement services. With skilled staff, the necessary resources and available beds, care homes can offer health and social care rehabilitation support.

Over to the experts... With integrating health and social care proposed by 2018 could care homes form a step down and alleviate pressure on the NHS? With a reluctance to redistribute the NHS budget to enable social care to take a larger role in assisting the NHS, could the use of care homes in this instance open the door for such a move?

Great opportunity for independent sector Paul Saper Managing Director LCS International LCS encountered health hotels in the United States around 8 years ago. These were predominately linked to Aptium Oncology’s cancer treatment centres, then run by Astra Zeneca, Memorial Sloane-Kettering and Cancer Treatment Centres of America. Patients or caregivers could be accommodated in the hospital or nearby hotels. Providing convenience at attractive rates, the facilities also allowed patients and caregivers to interact with others in similar situations, discussing navigating the medical system, treatment-related decisions and quality of life during and after cancer. Not surprisingly, Sir Robert Naylor’s UCLH, who work closely with the largest US independent hospital group, HCA, is a leading advocate of hospital hotels in this country. Karol Sikorski, Clinical Director and Founder of Cancer Partnerships UK, who has regularly commented that over three million people will be living with cancer by 2020, advocates that having someone with you during your treatment can

provide comfort and recommends this whenever possible. He has also argued that hospital hotel provision aids the political argument for more provision in specialist centres rather than provision in every local hospital. In the US there is not only focus on different types of cancer treatment and specialist treatment centres, but also on the variety of cancer rehab services that can help patients through all phases of treatment, including physiatry – the medical discipline concerned with restoring and improving patients’ function and quality of life. This links into post-hospital or post-acute centres caring for patients with stroke and neurological conditions, cardiac-related problems, pulmonary impairment, joint replacement as well as oncology, where hospital acute care around-the-clock is no longer needed, but a high level of clinical and rehab care will hasten recuperation. This is the segment of the market where UK independent providers see greatest opportunity in future.

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demand,

less money

whatâ&#x20AC;&#x2122;s got to give? The recent report by the Association of Directors of Adult Social Services (ADASS) illustrated the further impact that more budget cuts were going to have on the social care system. Professor Martin Green OBE shares his vision of how the system needs to change to survive on an ever-decreasing pot of money with an ever-increasing demand for services.

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A substantial squeeze on services and fees to providers was recorded by the latest annual survey of social care budgets carried out by ADASS. The survey highlighted that, despite resources being transferred from the NHS to local authority-funded social care, another £800 million is planning to be saved by April 2014. In the last three years, some £2.68 billion savings will have been made by adult social care - 20 per cent of net spending. Although many savings have been achieved by increased efficiencies, they weren’t simple `back-office’ adjustments, but were gained by ‘providing different, more cost-effective packages of care, or reduced levels of care.’ Facts and figures form the report can be found in the panel. These progressive reductions in the amount of money that local authorities have to spend on social care sit alongside enormous increases in need. Also, at a time when resources are shrinking and need is increasing, politicians have been irresponsibly raising public expectations about the system. Those of us working in social care know that the current system is broken and unsustainable. The fact that we have communicated it to politicians seems to have passed them by and they’ve continued to pretend that you can make adjustments to the current system, when we all know that it is not fit-forpurpose and needs radical change.

Radical change This radical change isn’t only required within the system, but it’s also necessary to have a different conversation with citizens about what’s affordable within the current fiscal envelope and what’s sustainable.

The debate needs to focus on more than older people; it needs a complete realignment of the current system, a change in our view about the health service, and above all a debate about some of the inequalities. So much of the social care budget goes into supporting younger people and this is disproportionate compared to the money allocated for the larger number of older people. The debate is going to be incredibly difficult because if we’re going to have a degree of fairness across the system, there will be losers and winners. Politicians struggle with telling the electorate tough truths and at a time of austerity, with the general populace getting more disillusioned with politicians and disconnecting from the political process, it’s going to be particularly difficult.

Balanced system The debate also needs to include the health service and our expectations of this publicly-funded system, which isn’t fit for purpose and, despite enormous amounts of money, isn’t delivering to the required level. The health service takes up far too much of the budget, leaving social care as the poor relation. It was founded in a totally different world. The current model of healthcare is based on a sequence of diagnose, intervene and cure. In reality, most patients are living with long-term conditions and have co-morbidities. They cannot be cured. We need a 21stcentury system to enable them to live well and manage their conditions. In this system, you would expect funding to be about 50/50 between health and social care. The current system spends about £121 billion on health and only around £8 billion

on social care. This is neither sustainable nor efficient, but it is the reality. The challenge for politicians is to lead us into the new era of a more balanced system. Of course, this involves dismantling some of the health service to get better outcomes and improved efficiencies and, as any politician knows, the moment the spectre of a hospital or service closure appears then politicians often lose their seats. Sadly, the imperative of short-term political survival seems to outweigh the need for longterm, sustainable solutions.

the deBates We require a debate that enables people to talk about the tough choices and to identify clearly that some things won’t be publicly-funded. I attended a recent debate around IVF and hip replacements. To me, it seems illogical to deny treatment to a person who is already alive whilst prioritising creating another life, which we may not have the money to support. These are very tough debates and will cause enormous controversy, but they’re debates we need to have to achieve sustainability for our services. We also need to talk to citizens about their lifestyle and preventative health responsibilities. How do we deal with citizens who sometimes abuse the service, by missing appointments, which are extremely costly, or ignoring preventative health messages?

FutuRe Funding The current Government committed to a new approach to funding and the Dilnot proposals offer an opportunity to establish much more clarity of the individual’s role in paying for care. However, this won’t cure all our

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more demand, less money - whats got to give?

health and social care problems, and many citizens don’t realise that they’ll still have to pay their hotel and accommodation costs. I find it bizarre that the taxpayer pays to keep criminals in prison who aren’t forced to sell their assets to pay for their stay, whilst forcing older people to sell their homes to fund the costs of their care. These are very controversial and difficult debates, but they are the debates that need to happen to enable us to support the numbers of people who will need care. To meet future needs the system requires flexibility from care providers and must enable them to change what they do. The growing challenge is dementia. If we’re going to rise to this challenge, we need systems and services flexible enough to support people as they move through their journey. Health must focus on prevention and offering people the drugs, or services, that will support them to maintain cognitive function for as long as possible. The social care system will need to provide a range of services that enable people to live well for as long as possible. We also need more support for carers.

with a condition like dementia, services such as night-sitting, re-enablement and respite will all be focused. Providers need to be creative and innovate around their communities’ needs. However, providers alone can’t change the system. Care services have traditionally led innovation and development, but often this has been stifled by a lack of vision from commissioners. If services are going to develop, be longterm and sustainable, then commissioners have to start rewarding innovation and giving it a longer funding cycle.

PoweR to the PuBlic As well as a change of policy by commissioners, I hope there’ll be more devolution of resources to the individual, so they can make informed

choices about the services most appropriate for their needs. We’ll then see a market develop around the needs and aspirations of local people rather than being defined and developed by a local authority or health community. We need to measure our successes and prove our worth. I believe there are three distinct measures that services should try to judge themselves by: user and carer experience; clinical and care outcomes; and efficient and effective use of resources. The current system focuses too much on cost, not value, of services and we have to shift this to efficiencies and measure services on their efficiencies and outcomes not just their costs

change is essential The world is moving in a

new direction, it can’t sustain our current system and deliver everything to everyone. The longer we leave the difficult decisions the less room we have for manoeuvre. Politicians need to lead the agenda and sometimes tell people what they need to hear, rather than what they want to hear. Sadly I don’t believe we’ll get to this point until the system starts to implode and then it’ll be too late. If politicians cannot show leadership, then we’ll have to and we must find the answers to these enormous questions because it’s our only route to survival and sustainability. cmm Professor martin green oBe is chief executive of the english community care association. martin.green@ecca.org.uk

ADAss Budget survey 2013 summary Key Facts • Annual savings of 20% (£2.68bn) of reductions will have been achieved by March 2014 from adult social care (ASC) budgets. • £795m savings are planned for 13/14 on top of the £1.89 billion achieved in the last two years. • ASC budgets remain at just over one third of total council budgets (34%). • Councils are reporting a demography pressure of 2.7% (£372m) of ASC budgets in 2013/14. It is believed that this figure is understated and is at least 3% of budgets.

caRe homes oF the FutuRe

• Only 76% (£282m) of calculated demography pressures have been funded by local authorities for 2013/14,

The care home of the future should become the community hub for managing long-term conditions. Staff are already some of the most expert in the system at dealing with conditions like dementia and in future, we need to ensure that this valuable resource is available more widely to those caring in the community. People will go to care homes to receive information about their condition, carers might be trained to look after someone

• 4.6% of savings are through increased income (£36m) compared with £77m increased income last year.

compared with 82% last year. • 82.3% of savings made in ASC are through efficiencies (£651m) compared with £688m last year. • The remaining 13% of savings are service reductions (£104m) compared with £113m last year. • Eligibility thresholds within councils were only changed in three councils who increased their eligibility from ‘moderate’ to ‘substantial’. • 87% of councils have set their eligibility for 2013/4 at substantial or above. • Only 37 councils (25%) formally agreed with their respective PCTs a plan on how to spend the health reablement monies. • Spend on prevention (£588m) in 2013/14 represents only 4.2% of ASC budgets. • 45% of councils gave no inflation to older people’s care homes in 13/14. 60% gave nothing for physical disability, 64% nothing for learning disability and 65% nothing for homecare. • Of the £806m reported as received by councils from the NHS Transfer in 2013/14 (out of a total of £859m), 32% has been allocated to avoid cuts (£253m). 14% allocated to cover demographic pressure (£113m), 18% allocated for investment in new services (£140m) and 36% has yet to be allocated (£291m).

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Feeling Settled guidance for providers and commissioners

The National Development Team for Inclusion (NDTi) has partnered with Choice Support and Golden Lane Housing to help improve housing rights and security of tenure for people with learning disabilities by developing the Feeling Settled Toolkit. The new toolkit builds on the original Feeling Settled: a guide for those involved in changing a service from a residential care home to supported tenancy where people stay in the same place, which was published in 2011 and set out the steps for changing registered accommodation and care into supported tenancy for people with learning disabilities. It offers guidance for supporting people with learning disabilities living in registered care homes, who would like to have greater security of tenure, more choice and control over their funding but at the same time are settled and would prefer not to move.

a lead agency identified. This group will set out a clear business plan (including a communications strategy to make sure that all interested parties stay well informed) and will oversee the delivery of the process. ‘Leadership’ of the process by one agency may prove useful. This will lead to a person-centred Individual Pathway for each person living in the service setting out how they will be engaged in the process and whose responsibility it is to keep them at the centre of everything that is happening.

individual Pathway

The new Feeling Settled Toolkit provides managers, planners, people and families with examples of good practice and valuable resources for each step of the person-centred Individual Pathway proposed in the original report. The Individual Pathway is at the core to this Toolkit, emphasising that although there are many challenges in effecting change, it is essential that the person stays at the heart of the process throughout.

Changing from a residential care home to supported tenancy service when all (or most) of the people served stay in the same place is a complex process that requires partnership working, together with careful and detailed project planning and clear communication. In Feeling Settled, it recommends the establishment of a project group made up of key stakeholders with

the new toolkit

Rob Greig, Chief Executive, NDTi said, ‘Helping disabled and older people gain greater housing rights and security of tenure is something that people say they want, and that policy encourages. However, some people want to achieve those things without having to move from their current housing or change the staff who support them. The Feeling Settled Toolkit helps both commissioners and providers to do this. It emphasises how this is more than just a legal or bureaucratic change, but is fundamentally about using person-centred approaches to listen to the person and ensure they end up with choice and control over the housing and support they want and need.’ cmm the Feeling settled toolkit can be downloaded from the ndti website here: http://www.ndti.org.uk/uploads/files/Feeling_ settled_toolkit_april_2013.pdf the original Feeling settled can be downloaded from here: http://www.ndti.org.uk/uploads/files/Feeling_ settled_Final_Report_February_2011.pdf

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SURREY CARE HOME FOR SALE

On the instructions of the joint administrators RSM Tenon

INGLESIDE CAREHOME

Roke Road, Kenley, Surrey CR8 5DY • • • • • •

Freehold 33 bed care come Weekly charges guide: personal care single £400-£780 ERV £700 p/w per bed - £1.2M per annum Potential to extend Being sold as a going concern

•

Guide price £POA

VIEWINGS STRICTLY BY APPOINTMENT ONLY

Rodney Bishop Steve Oliver E. ingleside@inspireland.com E. steveo@paramountproperties.co.uk T. +44 (0)20 8088 9955 T. +44 (0)20 7644 2304

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We care about your business We have over 10 years experience in providing work-based qualifications to the care sector. Whatever the size of your organisation, Care Training East Midlands offers a personalized, bespoke service; from short courses and workbased qualifications, to recruitment services or a fully comprehensive Apprenticeship scheme.

Mercy Cofie-Cudjoe Alexandra Lodge Care Home To find out how we can help your business, call our Employer Engagement Team on 0115 9599 544 or email info@ctem.uk.com.

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SOFTWARE IS NO LONGER JUST FOR THE LARGER GROUPS. WHATEVER YOUR SIZE OF BUSINESS AND TYPE OF SERVICE THERE ARE NOW PACKAGES SUITABLE FOR YOUR COMPANY’S NEEDS AND PRICE RANGE. CMM THROWS ITS SPOTLIGHT ON SOFTWARE AVAILABLE FOR THE CARE SECTOR.

SPOTLIGHT ON…

S O F T W A R E Whether it’s a PC, Mac, tablet, smart phone or other personal device, software is fully integrated in daily living. If it isn’t fully integrated into your business, it’s time to see what’s out there. Designed for every type of care service, operational software can help you with everything from care planning to staff management, rotas, training and accounting. Reporting can be made easier and inspection reports, occupancy reports or care plan reviews can be available with a few clicks of the mouse or taps of the touchscreen. Many packages offer you the ability to have the functions you want, without having things you may never need. They can be tailor-made to your business or you can add on modules as you need them.

They can even integrate with any existing packages you may have, such as Sage. The software can also be taken away from the main computers and on to mobile or handheld devices. With the growth of touch-screen tablets and smart phones, new software is also being developed to exploit this approach and bring it to the resident. With packages offering reminiscence, communication aids and connecting people, social care software keeps innovating. The following organisations offer a range of different software for the care market. Please contact the organisations directly, mentioning CMM to find out how they can meet your company’s needs.

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ADVANCED HEALTH & CARE

As more and more care organisations are choosing to invest in better IT solutions in order to improve efficiency and cut costs while improving quality of care, CareSys from Advanced Health & Care is one solution which is becoming increasingly popular within the care sector because of its ease of use. It has also been specifically designed to add value to care organisations. CareSys is used by more than 3,000 residential, nursing and specialist care homes across the UK, catering for all types and sizes of care organisations and offers a fully-tailored solution and licencing options depending on the users’ needs. The solution has been implemented in some of the largest care home groups, specialist care and learning disability organisations in the country. The fully-integrated software application is available as a complete package or as individual modules, allowing information to be shared cost-effectively amongst any number of different people at different locations. By eliminating time-consuming and disconnected manual processes across different systems, CareSys allows care staff to focus on delivering joined-up care, whilst managerial and administration staff can ensure correct reporting and compliance; therefore securing better outcomes for service users.

CareSys enables care organisations’ staff to focus on delivering high quality care, rather than spending that time on cumbersome administrative processes. Modules available include: • Time and Attendance, • Person-Centred Care, • Staff HR, • Finance, • Care Scheduling, • Equipment Maintenance, • Behaviour Support, • Enquiries / Marketing, • Income / Billing. Advanced Health & Care also provide market leading software for homecare agencies, supported living providers and local authorities. Advanced Health & Care use innovative technology to allow organisations of all sizes to increase efficiency and compliance, giving them more time to deliver great care. The Advanced Health & Care suite of products includes: Adastra, Adastra 111, Advanced Community, Advanced Mobile Communications, Carenotes, CareSys, Crosscare, iConnect, iNurse, & StaffPlan.

Telephone: 01233 722700 • Email: ahcmarketing@advancedcomputersoftware.com

• www.advancedcomputersoftware.com/ahc

ASSISTIVE PARTNER

If you operate by providing equipment or care; by managing inventory or assets; by providing services or helping people choose what meets their need; Assistive Partner can help streamline many of your processes. We’re very experienced operations professionals. Cutting your costs; improving your service.

• Increased operational efficiency and improved customer service, • Reduced costs, paperless operations, mobile working, • Improved management information, • Online ordering portals, • Purchasing, inventory, logistics and warehouse management, • Barcode scanning and mobile workforce apps, • Track and trace, workforce and assets, • Sales and hire. • CRM and e-campaign tools, • Document management.

Our UNIQUS product is software for people who want to achieve some or all of the following: • Cloud-based enterprise software,

Assistive Partner designs and sells various proprietary software applications. Most of these are particularly tailored for healthcare equipment and services. The company started trade in March 2007. Our cloud-based solutions are hard at work in four countries.

Telephone: 0844 335 6791 • Email: info@assistivepartner.co.uk • www.assistivepartner.co.uk

CACI

CACI is a leading UK provider of software solutions for independent and local authority care providers in residential, domiciliary and agency care. Its innovative care management software solutions enable organisations to optimise business processes, reduce administration and so increase spend on all important service provision. Used by some of the largest care providers in the UK its enterprise solutions are scalable and robust. Its products include: • OfficeBase Care and Support Management Software: developed to help care providers optimise their resources and to balance the operational needs of running their business with the provision of person-centric services at an enterprise scale. This fully integrated care management system is designed to manage the core processes around service delivery, including service user referral and care planning, carer scheduling and allocation and staff timesheet recording, through to contractual billing and staff pay. In each of these areas the software allows optimisation of business processes in order to achieve operational and financial objectives, whilst satisfying care standards. • inTOUCH Mobile Working Solution: the first mobile software solution in the UK to address the needs of care workers in the field. Deployed on ‘smart phones’, inTOUCH enables dynamic rostering, allowing carers to download their specific up-todate service user schedules whilst also providing them with contextual information and allowing them to provide real time feedback forms with the ability to capture outcomes. It also supports lone worker safety and integrates with the OfficeBase Care and Support Management solution.

CACI works alongside a number of organisations who share its vision for a high quality care and support system. These include independent providers: • Housing 21, • Leonard Cheshire Disability, • Radian. Local authorities: • Barnsley Metropolitan Borough Council, • Caerphilly County Borough Council, • Lincolnshire County Council. Awards: • The Good Communication Awards 2011 – Mobile Technology Award - for the codevelopment in association with Barnsley Metropolitan Borough Council of the inTOUCH care provider mobile working solution. • Social Care Accolades 2011 (Care Council for Wales) - Improving Welsh Language Provision Category - for the co-development in association with Gwynedd Council of a unique bilingual version of CACI’s inTOUCH care provider mobile working solution. • Orange: Best Use of Technology in Business Award 2008 - for the co-development in association with Barnsley Metropolitan Borough Council of the inTOUCH care provider mobile working solution. • Care Awards: IT Innovator of the Year 2008 – for the co-development in association with Barnsley Metropolitan Borough Council of the inTOUCH care provider mobile working solution.

Telephone: 0208 893 9039 • Email: careandsupport@caci.co.uk • www.caci.co.uk/careandsupport

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spotlight on… software

CARE MANAGEMENT SYSTEMS

Imagine the inspectorate visits, unannounced, they required historical data for one of the residents. You provide this in minutes. Or, you require information for a Mental Capacity Deprivation of Liberty decision. Again, in minutes, you are able to produce this. How? This is CareDocs, a complete care planning and home management system. Designed by care home owners, so it’s easy to use, records information you need and gives your staff time to care. The system promotes easy-to-follow assessment, which using the information gathered, CareDocs automatically generates a draft care plan, saving hours of work. At this stage, the care plan is personalised but every section can be edited or supplemented with other information enabling it to become a truly person-centred document. The on-going maintenance and update of the care plans is a simple and straightforward process. All text and content can be amended to reflect changes in circumstance. All previous content is saved for future reference creating an invaluable record of care history. The care plan, in conjunction with daily occurrence notes and forms, give you comprehensive guidance and evidence which will encourage best practice and support good care provision.

Daily occurrence notes are categorised as different event types; using our system you can filter this information allowing you to produce a precise historical event log when you need it. Also, the system prompts you to record all resident experiences (eg doctor visits and hairdresser appointments) and indicate their mood; filter these events to analyse patterns in resident behaviour. You can then use this to make the necessary adjustments to the provision of their care. CareDocs can monitor residents’ and staff records and ensure that equipment servicing schedules and daily checks are completed on time. All information can be stored and retrieved with ease. We supply CareDocs installed on desktop or laptop computers – no programmes to install or download. If you want more than one system, we provide a server system and additional clients to meet your needs. All our subscription packages include training, technical support and regular updates. We also provide you with initial training when we install the system so that you get the most from CareDocs right from the start.

Telephone: 0845 500 5115 (Sales) • Email: info@caredocs.co.uk • www.caredocs.co.uk

COLDHARBOUR SYSTEMS

Coldharbour Systems Ltd is the market leading supplier of software solutions for private and charitable care providers. Founded in 1986, Coldharbour Systems Limited has over 27 years’ experience in supplying integrated solutions to the healthcare market. We have a portfolio of nearly twenty industry specific modules that cover Residential Care, Community Care, Children’s Nurseries, Acute and Mental Healthcare services and Specialist Education. The undisputed industry leader reputation that Coldharbour enjoys has been built on customer loyalty, won through many years of excellent service for hundreds of clients across thousands of sites over the UK. Coldharbour’s client list reflects our success in delivering complex systems and we have continually demonstrated our strategy for continued innovation and development, aligning it to the business requirements of the private and independent care sector. Furthermore, to help maintain our position as the market leader we run a number of focus groups and product strategy days enabling our clients to have input into our product roadmap. Residential Care With the focus in this sector on consolidation and controlling costs, particularly staff costs within the business, Coldharbour has developed a touchscreen biometric time and attendance solution. Coupled with the industry proven billing and invoicing modules, Coldharbour offers a complete solution for any residential care provider. Community Care Our product development strategy has been very focused in this area including contract

billing, integrated call monitoring and the provision of a mobile solution for care workers. Focus has also been given to acute and complex homecare and re-ablement services as the sector rapidly moves in this direction. Mobile Point of Care Solution Coldharbour Systems Mobile Point of Care solution provides community care operators with an integrated mobile point of care and administration system. Uniquely, the application is both device and airtime provider agnostic. It is based on GPS technology which automatically records the location of the carer and provides location information of the service user. Time and Attendance Solution As the industry is challenged with minimal fee increases, the control and management of staff costs has become a major focus point. Our intuitive touchscreen solution, utilising biometrics and self-service functionality helps achieve significant staff cost reductions and efficiencies. e-Compliance module A true cross market application allowing any care organisation to design its own electronic form content and establish automated workflow and necessary interventions to meet its specific care and compliance requirements, ensuring forms and data capture is standard, auditable and reportable. Additionally, we have our own corporate accounting solution with a unique drill back facility into our core products, a range of robust business intelligence tools, incorporating dashboard facilities and a fully managed hosted services platform and disaster recovery service.

Telephone: 01275 850500 • Email: info@coldharbour-systems.co.uk • www.coldharbour-systems.co.uk

MALINKO CARE

Malinko Care need to worry or backing up you. Consists

- web-based so you don’t about installations, upgrades your data, we do all that for of four integrated elements:

Scheduling: Rotas with an easy drag and drop interface. Send and collected detailed job information, all updated live via iPhone or Android devices using our mobile app. Service User Record Management: store all the information about your clients. Record

items such as next of Kin, doctors’ details and add your own custom fields. Upload files too, so you can store care plans with your service user records. Carer records: You can store HR information about your care staff and store copies of relevant documents such as CRB check or driving licence. Along with all the work history you can see all information about your staff within a single system. Detailed reporting: Range of standard reports such as payroll, invoicing runs or marketing as standard, plus customised reports.

Telephone: 0161 850 0111 • Email: antony@liquidbronze.com • www.care.malinkoapp.com

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Why settle for just a piece of the pie? When you can have a software system that can do it all CareSys, from Advanced Health & Care, is the leading integrated care management solution, providing a single enterprise-wide software package, from one of the UKâ&#x20AC;&#x2122;s leading providers of IT. To ensure your business expands with the fourth largest and fastest growing IT organisation by contacting 01233 722670 or visit www.advancedcomputersoftware.com/pie

www.advancedcomputersoftware.com/ahc

Information for Care. Everywhere.

Advanced Health & Care Limited is part of Advanced Computer Software Group. Registered in England, company number 02939302. Registered Office: Munro House, Portsmouth Road, Cobham, Surrey, KT11 1TF

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Your business... ... one solution. CACIâ&#x20AC;&#x2122;s OfficeBase software provides unparalleled functionality to drive your care and support business, ensuring a single version of the truth.

020 8893 9039

careandsupport@caci.co.uk

www.caci.co.uk/careandsupport

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spotlight on… software

FIRST SOFTWARE SOLUTIONS CAREBLOX

Remove the hassle of timesheets, improve accuracy in payments to staff and reduce your payroll costs with our innovative Time and Attendance system. The system includes a web-based rostering system and a local touch-screen terminal, which acts as a clocking-in system. It allows staff to view hours worked, check remaining holiday entitlement and shift details, and make requests for holidays. Time off-site and agency and bank hours can also be captured. A digital image of the user is captured as they clock in, which means ‘buddy clocking’

is not possible. The web-based software provides a highly efficient and secure management tool, providing sickness and holiday records, customisable templates for rostering, automated bank staff selection, simple management of exceptions and the facility to export hours data, a payroll system or bureau. Time and Attendance from First Software Solutions Ltd - CareBlox.

Telephone: 01507 610092 • Email: info@first-software.co.uk • www.careblox.com

FRETWELL-DOWNING HOSPITALITY

Saffron is a web-based Catering Management Solution that has been used in the healthcare sector for over 25 years, provided by Fretwell-Downing Hospitality (FDH). Saffron encompasses the entire catering process from management of purchasing, stock, wastage and consumption calculation, recipe and menu management including production planning with full CPU controls and nutritional analysis.

FDH are also providers of Saffron Patient Ordering for iPad or Tablet PC which is revolutionising healthcare catering. Saffron Patient Ordering enables orders to be taken very close to the mealtime with the ability to show a picture of dishes, nutritional content and identify patients that need help with their meals (red tray). Saffron is currently helping over 100 healthcare providers streamline their catering operation and improve patient experience.

Telephone: 0114 281 6060 • Email: info@fdhospitality.com • www.fdhospitality.com

LNT SOFTWARE

LNT Software truly understands the care sector. We are committed to providing the highest quality software solutions to help your business. We have been designing and delivering care home management software for nearly 15 years, providing our CoolCare system to care homes throughout the UK and Ireland. CoolCare3 has been built by care home owners for care home owners. Our goal with CoolCare is to offer an affordable, practical package that will be easy-to-use and grow with our clients. With our low cost of entry in to Coolcare3, your £90 monthly subscription includes all Coolcare3 elements plus support, maintenance and, of course, training. We do not believe in modules or extra bolt ons. There are no software add-ons or modules required - everything is included in our package, ready for you to choose to use as you grow. Time and attendance This is an often over-looked benefit of CoolCare. Being able to manage staff in an efficient, fast and intelligent way can help you significantly improve your care facility in terms of its productivity and, ultimately, profitability. One way to ensure you are getting the most from your team, and to discover better ways to manage your team’s working hours, is to integrate employee time and attendance systems into the business. CoolCare works by letting your employees clock in to work using our iButton clocking Telephone: 0113 3853853 • info@LNTSoftware.com

in systems that automatically put them on the right shift at the right time and being paid for the right job role. Being able to export your client payments and payroll to your accounting packages with peace of mind and in a few minutes, will also greatly ease your administration overhead. Care planning Being able to appropriately and correctly care for those people living with you should form the very ethos for which you operate. CoolCare helps by giving you the medium to collate all this information in a compliant and easily-accessible manner. Company analysis With CoolCare’s Operational Analysis, you can simply click a button and access the realtime data whenever you wish, including in great detail how a home had performed over the last four quarters. Complete with average weekly fees, occupancy and the fill rate. Recruitment and Staff HR Maintaining your staff records can be a lengthy task, updating next of kin details, monitoring when a Visa expires or when a member of staff is sick yet booked on a course. All of these things can be managed by our in-depth HR Management system. And much, much more including: Document Management, Messaging Centre, Enquiry Management, Training, Virtual Notice Boards.

• www.lntsoftware.com

MY LIFE

My Life Software is a provider of touch screen technology which enhances the life of those with dementia. This is achieved through a Digital Reminiscence and Digital Life Story Books which engages the individual and stimulates them, helping to reduce agitation. Digital Reminiscence Therapy is a form of cognitive stimulation therapy that has been proven to help with cognitive decline. Therapy of this nature is powerful and effective for

the person with memory problems and also an aid for the caring families and friends. It helps carers and family members communicate more effectively when sometimes communication is difficult. Our product has been well-researched with the help of our clinical partners and academia and is evolving a new dimension in digital therapy and is in place in major NHS hospitals, care homes and in the community.

Telephone: 0161 941 6610 • sales@.mylifesoftware.com • www.mylifesoftware.com

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Specialist dementia training DVD packages • Improve care outcomes for people with dementia. • Enhance your reputation as a provider of excellence in dementia care. • Equip staff with the skills and conﬁdence to provide compassionate, person-centred care. • Provide staff with specialist training tailored to their own work setting. For staff in a residential care setting, Tomorrow is another day covers dementia awareness and person-centred approaches. Already popular with many care providers, it is a key addition to your training library. For staff caring for people at home we have a new dementia awareness package, Supporting people with dementia at home. Two thirds of people with dementia live in the community, so this is an essential training tool for any care agency.

Alzheimer’s Society’s specialist training DVDs cost just £249 + VAT each Order your copy today, or contact us for more information T 01904 633581 E: dementiatraining@alzheimers.org.uk Both packages include a DVD with film footage as well as a CD Rom with all notes and training exercises. They are designed to be delivered by you, direct to your staff, and cover the basics in dementia awareness, communication, well-being and person-centred approaches. On completion of the training learners can take a short certificated assessment which provides successful candidates with an Alzheimer’s Society certificate and badge – contact us for more details. Alzheimer’s Society also offers a range of products to assist people with dementia in their daily lives – please visit our online shop at alzheimers.org.uk to view the full range, and for details of how to place an order. Alzheimer’s Trading Ltd (registered company no: 02737333) is a wholly owned subsidiary of Alzheimer’s Society (registered charity no: 296645) to which it Gift Aids all taxable profits at the end of the financial year.

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spotlight on… software

sIMPLY UNITe

Gem software helps get digitally excluded people online. Gem has been specially designed to enable people, regardless of their age or technical ability, to stay connected with friends and family. It incorporates Skype, email and photo sharing and encourages them to pursue hobbies and interests online. Gem is designed to work through a touchscreen computer and is aimed at people in

residential care or supported living. Its impact is stimulating, engaging, fun and entirely life-enhancing. There is a SimplyUnite Gem package to suit every budget and device – choose from software only to a fully-managed and supported hardware service. In addition, our iPhone and Android Apps for the service user and their families mean there has never been a better way to keep families connected.

Telephone: 0161 941 6610 • info@simplyunite.com • www.simplyunite.com

WeBrosTer.NeT

Webroster.net is an online workforce management and scheduling system designed to save time and money through automating and streamlining manual processes. Webroster.net matches resources to clients to create rosters, generates timesheets and processes invoices and payroll. A range of additional modules are available to enhance the basic system.

and PhotoTrac™ and Webroster Mobile which use barcode scanning.

Three real time electronic monitoring systems are available for tracking time and attendance: VOIPTrac™ which uses landline phones to check in and out of bookings

Other additional modules include SMS, Document Management, Travel, Mapping and Audit.

Webroster.net supports remote working through its app, ‘Webroster Mobile’ giving field staff access to client and booking details, allows them check in/out of bookings and use the panic button. Staff and clients can also access their own online portal from home to view schedules and print worksheets.

Telephone: 01733 311599 • Email: info@webroster.co.uk • www.webroster.co.uk

ZesT care

A real time solution to many of your home management issues including Time and Attendance, Rotas, Budgets, Resident Records, Invoicing, Occupancy Analysis, Training and Reporting Tools. With a low upfront cost and a budgeted monthly licensing fee Fusion enables providers to manage systems, processes and care with transparency, best practice and high standards. Home/Group data analysis will keep you in real time control of your employee and service user records including time management, multi contract invoicing, budgets and occupancy. Fusion is a web-based software technology with an easy to operate modular software system. With live updates and system back-up and on-site training it really is a case of just switching to a simple system to gain greater efficiencies and profits. Fusion is a reliable and flexible care management system backed up by in-depth training and support which is easy to understand and operate. Zest ensures a high level of support and maintenance which strengthens our business relationships and work with our clients to maximise the use of the software. We pride ourselves on our outstanding customer service. We make it our business to get to know you and see our association as a partnership; this will help us implement our solutions based on your needs thereby creating an honest and loyal working relationship. Support and product upgrades are included in your standard monthly licensing fee so no nasty surprises. Zest prides itself on our ability to communicate effectively with all levels of technical knowledge. Our training team won’t leave you until you’re up to speed and working to your full potential.

To give you absolute peace of mind we believe that no one else can achieve our support levels. We arrange a no cost annual face to face review with you to ensure you are utilising our system to its maximum effectiveness in relation to your business requirements and that you are up to speed on all our product enhancements. Our process completes the full circle from installation, training and integration into your business with second to none aftersales care so that you don’t feel alone once the system is in place. Modules: • Time and Attendance, • Rostering,• Staff Training Records/Reporting/Planner, • Budget Reporting,• PDF Reporting Tools, • Invoicing, Multi Contract and Individual, • Billable Extras, • Enquiries, • Diary, • Occupancy Reporting Tools. Fusion can be purchased as stand-alone Time and Attendance/Rosters or Service User or as a whole package. Available for long-term elderly care, learning disability, specialist care and children’s nurseries. Training is one to one on site with support available via telephone, live online, email and one to one. Clients include - Orchard Care Homes, Springcare, Herefordshire Care, Prestige Group, Peterborough Care, Netley Partnership, Balcombe Care, Claridge Care, Affinity Care Homes. Pricing - Initial Installation /Set Up including Training Day: £750, Optional Training Day: £380, Monthly Licence and Support: £88, Biometric Clocking Device: £445.

Telephone: 01132 863056 • Email: martin.jones@zestcare.com • www.zestcare.com

Next edition: Who’s who in banking and ﬁnance If you would like to feature in the next who’s who please email editor@caremanagementmatters.co.uk or send a tweet to @CMM_Magazine www.caremanagementmatters.co.uk 40 | cmm july 2013

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100,000 social care apprenticeships by 2017: issues for employers The GovernmenT is commiTTed To increasinG The number of apprenTiceships sTarTinG work in social care. rhidian huGhes explores The currenT issues for employers based on work wiTh The naTional care forum. The Caring for our Future: Reforming Care and Support White Paper sets out to build capacity and capability in the social care workforce. A key policy initiative is to increase the number of people starting apprenticeships to 100,000 by 2017. The numbers of starts on the health and social care framework are rising, with over 67,000 in 2011/12, representing a 25 per cent rise since 2010/11.

Shaping the apprenticeShipS workforce For employers, there are a number of factors shaping the future care and support apprentices workforce. • Funding – Changes in funding allocations to adult social care could shift the nature of relationships with care providers, leaving less money for learning and development, including apprenticeships. • National policy and strategy – General and specific Government support for apprenticeships will drive demand. • Demand for adult social care – Demand for care and support is rising and the sector needs to secure the supply of the future workforce. • Quality – Concerns about the quality of training and the experience levels of young people in apprenticeships reinforce the perception by employers (particularly of smaller-sized organisations) that apprentices are resource intensive. • Perceptions of, and attitudes towards, working in social care The public has negative perceptions about social care as a career. Alongside these are drivers affecting the future apprenticeship workforce. Some of the possible drivers affecting employers demand for apprentices, as well as the factors shaping supply are shown in the panel opposite.

‘we are currently not running any… apprenticeships as we took the view that the sector is not stable enough for us to effectively support this…’ - ncf member organisation

the emerging picture For nine years, the National Care Forum (NCF) has been undertaking a personnel survey of its membership. In 2012, 40 organisations (58 per cent of members) responded. Of these, 27 gave detailed responses about apprenticeships, with 18 (67 per cent) reporting an in-house apprenticeship programme, or actively considering or developing one, and 9 (33 per cent) not planning to establish a programme. The NCF pay, terms and conditions survey in 2012 asked: ‘Do you, or are you planning to, offer an apprenticeship programme? If so, for which job roles?’ In the responses, 29 of 48 organisations questioned recorded active apprenticeship programmes for a range of roles, although the main focus of apprentices is direct care and support roles. The Centre for Workforce Intelligence (CfWI) analysed the NCF data to identify a relationship between the number of apprentices and the number of overall staff. It found a strong link. It also found the number of apprenticeships was linked with the overall number of care and senior care staff in the organisation.

key meSSageS for employer Growing demand for care, changing expectations and personalisation require social care organisations to work together to build workforce capability and capacity. There is a real need to improve workforce intelligence to plan better for the future. Research activities offer valuable data and qualitative insights, and wider adoption of the National Minimum Data Set for Social Care (run by Skills for Care) to collect information about social care apprentices will be essential to inform this intelligence. The Government is keen to develop apprenticeships in smalland medium-sized organisations. The exploratory findings from the NCF survey suggest that apprenticeships tend to be offered in larger organisations and the challenge will be the wider roll out of the apprentices’ framework. Official statistics suggest the target for apprentices is on track although we will probably need to see an overall annual increase in starts at a little over ten per cent per year to achieve the

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‘We understand how apprenticeships can help the business by offering a route to harness fresh new talent. Skills shortages and recruitment difficulties are a threat and the apprenticeships can ensure that our workforce has the practical skills and qualifications our organisation needs now and in the future. These skills will increase productivity, improve competitiveness and create a committed and competent workforce.’ - NCF member organisation



100,000 ambition. The data also suggests that around a quarter of starters don’t complete their training. These figures may underestimate the true number, as those who leave within the first six weeks of training are discounted. There are workforce risks for employers, especially in relation to return on investment. It is important to maintain an on-going focus on the quality of apprenticeship schemes alongside the necessary growth in new workers. It is also crucial to recognise the wider workforce measures contained in the White Paper, such as raising the status of registered managers, which together all play a critical part in supporting the new apprentices’ workforce.

MORE INFORMATION

NCF data suggests strong link between number of apprentices and the number of care staff.

More information about this project is available on the CfWI website, including a summary paper bringing together workforce intelligence on growing the apprenticeships workforce: www.cfwi.org.uk/workforce-planning-news-and-review/pressreleases/press-release-growing-apprenticeships-in-social-care CMM The CfWI and NCF Research Team included James Edmondson, Jane Evans, Rhidian Hughes, Des Kelly, Claire Silvester and William Murdoch. Rhidian Hughes is Head of Social Care at the Centre for Workforce Intelligence. rhidianhughes@me.com

IMPACTS ON EMPLOYER DEMAND Positive

Negative

• The relatively low wage levels make apprenticeships cost effective. • The integration between social care and healthcare may increase demand as new roles working across the apprenticeship framework are developed. • An increase in demand for social care may increase the number of workers required.

• Employers perceive poor return on investment in apprenticeships due to a lack of engagement by young people, high turnover, and the loss of trained staff to other organisations. • Some employers are dissatisfied with the quality of training and learning outcomes for apprentices. • Employers do not understand how apprentices can be incorporated into the business, they do not plan effectively and some believe roles have limited applications.

IIMPACTS ON LEARNER SUPPLY Positive • The Government policy of increasing apprenticeship starts will ncrease awareness among learners. • As more people have positive experiences of apprenticeships through supportive workplaces, there will be a positive impact on demand and retention. • The overall increase in demand for social care may increase the profile and awareness of career opportunities.

Negative • Changes in funding arrangements will make apprenticeships less attractive to people aged 24 and over working on advanced or higher apprenticeships. • A perception of low wages by interested learners may depress the number of apprenticeship starts. • Social care is perceived as a poor career choice, especially among young people.

CMM JULY 2013 ¦ 43

conference review

NCF ANNuAl CoNFereNCe 2013 reCogNisiNg the Future The 10th Annual Conference of the National Care Forum was held at Eastwood Hall in Nottinghamshire. The theme of Recognising the Future was intended to be a reflection on the 20th anniversary of the NCF providing an opportunity to think about how services have developed over the last 20 years and how they might look in 2033. Professor June Andrews, University of Stirling Dementia Centre, opened the event with an overview of the dementia challenge with practical ways in which services could develop and improve. Sandie Keene, President of ADASS, picked up on this introduction to reflect on the changing role of local authorities as commissioners, integration of care and health and the continuing pressure on public funding. The provision of end of life services and the Dying Matters Coalition were the themes for Eve Richardson, CEO of NCPC’s predictions for 2030 and Andrea Sutcliffe, CEO at SCIE, gave a perspective from SCIE as a champion of improvement and a key source of knowledge with a challenging reminder that expectations and demands will

14th and 15th May 2013

continue to rise. On the second day Mike Rungie, CEO, ACH Group’s thoughtful address provided an Australian take on age care services introducing the notion of ‘encore careers’ as a consequence of longer lives with changing roles and opportunities and a greater need to keep people healthy and active. Helen Sanderson, CEO of Helen Sanderson Associates gave a powerful illustration in her talk of Personalisation in Action which drew directly from her experience of managing transformation and change in different settings and the lessons for leaders. Finally, Jeremy Porteus, Director of Housing LIN, reminded delegates that integration has to include housing solutions. Between keynote speakers there was a series of provider responses and reflections which gave an opportunity to consider the implications of what had been said and in addition there were a series of workshop sessions on topical themes. The overall evaluations of the conference were very positive and well-received by all.

Derbyshire anD nottinghamshire Care ConferenCe the future of Care anD Commissioning 5th June, nottingham The Derbyshire and Nottinghamshire Care Conference and Exhibition brought together leading providers from the Derbyshire and Nottinghamshire regions to debate the future of care and commissioning in the region. Supported and organised by Care Management Matters in association with Derbyshire Care Homes Association and Nottinghamshire Care Association the full and interesting day was a fantastic forum for local providers given the pressures they face on a daily basis. Professor Martin Green OBE, CEO of ECCA delivered a thoughtful interpretation of the Care Bill and then chaired a lively panel including Brian Rosenberg, Chair of the Derbyshire Care Homes Association, Alan Pearce, Chair of the Nottinghamshire Care Association and Caroline Baria, Services Director Joint Commissioning Quality and Business Change at Nottinghamshire County Council. Delegates had a chance to put their questions to the panel and heard directly from Caroline about how the Council was approaching social care in the face of tighter funding. Main presentations included an informative providers’ guide to dealing with safeguarding proceedings by Stuart Marchant,

Partner at Bevan Brittan LLP. Roger Harcourt, Partner and Head of Healthcare at Shakespeares shared opportunities, threats and challenges facing the sector. Mark Ellis, Head of Social Care Banking Services, SME Banking, Lloyds TSB Bank gave an honest interpretation of market conditions, whilst John Lucas, Healthcare Partner at Hazlewoods LLP shared examples of innovation happening around the country for delegates to consider for their own businesses. Workshops also ran and focused on important operational topics. Nicki Wakefield of Straight Up Marketing gave a marketing masterclass, Maureen Hinds of National Skills Academy presented training for everyone, Rhidian Hughes and Jane Evans of Centre for Workforce Intelligence offered advice on recruitment and retention and David Collins of David Collins LLP discussed progress in judicial reviews for a better price for care. Chair, Robert Chamberlain, Editor in Chief of Care Management Matters brought the event to a close by summarising the interesting and thought-provoking day.

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what’s on?

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straight talk

straight talk Whilst the sector is still debating whether residential care or supported living is appropriate for adults with a learning disability, Simon Duffy argues that they’re both outdated and it’s time to move on.

simon duffy direCtor the Centre for Welfare reform What’s the problem with supported living? Over 20 years ago, Peter Kinsella returned from America as a Harkness Fellow and pulled together the Supported Living Programme. I was honoured to be asked to join Peter’s small team helping service providers find alternatives to group homes. Peter’s work was critically important in developing UK policy. By the combination of innovation and passionate advocacy, he helped us move towards a better understanding of our human need to live in real homes. Instead of trying to fit people into service models, he argued, we should treat each person as an individual and work with them to help them get the housing and support solution that’s right for them. In those days, supported living meant good support, one person at a time, with no fixed models.

But you might wonder are group homes really a problem? When you support people in a group home what you are really saying is that the price of getting support is to have only half a home. People cannot fall out with you, or the people they live with, without losing their own home. This is a breach of human rights.

When I attended a supported living conference last year it was very clear that now, when people use the term ‘supported living’, they just mean ‘a group home that isn’t a residential care home’. Supported living has not only just become another model it’s actually become the very model it was designed to challenge.

How can we do things differently? Maybe we just need to go back to basics. Perhaps we should accept the need for a variety of models, but these should be the natural models of ordinary life: • Some of us live alone - although I never liked it myself - some people really do; • Some of us live with friends - but few of us can bear to live with people we don’t like; • Some of us live with our partners - if we are lucky enough to fall in love; • Some of us live with our families - although we value independence as we grow older.

How did this happen? How did supported living lose its meaning? Part of the reason is that the term ‘supported living’ has become just one option in the official system. CQC says, ‘Supported living is where people live in their own home and receive care or support in order to promote their independence. If there is genuine separation between the care and the accommodation, the care they receive is regulated by CQC, but the accommodation is not.’ This definition also influences how service providers are funded. If you can avoid being registered as a care home, your funding will be different, and usually better. But this also means that service providers have an economic incentive to ensure that standards for supported living are as low as possible - making it easier to maximise funding and reduce costs. As the 33 per cent cut in social care continues to bite, it’s natural that to fall back on the mistaken assumption that ‘the more people we put together, the cheaper things will be’. This happens often. A good idea starts by doing good - by challenging and changing reality. But reality fights back; and so the good idea is converted into something much less challenging.

The UN Convention on the Rights of Persons with Disabilities states: ‘Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement.’ [Article 19a] This isn’t how our system works. We work in opposition and we are undermining people’s basic human rights.

These models are just the normal forms of home life. They’re not right or wrong - although they can be wrong for you at a particular point in your life. People are people and we all share the same desire to find the home that is right for us. It isn’t supported living we need, it’s human rights and the freedom to exercise those rights - and especially the right to have a real home of our own. A few years ago, a care home manager told me he was supporting someone who didn’t belong in the home. He wanted to help her move out. But he couldn’t because he was a care home manager. I replied, ‘Don’t worry, because you’re also a human being - and as a human being you are free to help her achieve her goals.’ Perhaps providers should think about it like that - how can we be more human - and how can we help people to realise their rights and live the life that’s right for them?

What do you think? do you agree With simon? Please email Cmm With your thoughts on this toPiC: editor@Caremanagementmatters.Co.uk

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2013/14

Will you be a winner in 2013/14? Nominations are now open for Accolades 2013/14 The annual Skills for Care Accolades celebrate the very best practice in social care and reward employers and organisations for commitment to workforce development and innovation. Achieving an Accolade proves you are improving the lives of people using social care services through workforce development.

Does this sound like you or your organisation?

If you provide a high quality service and invest in developing your staff we want to hear from you. You can also nominate yourself, another organisation or employer that you think would be a worthy winner of an Accolade.

There are eight categories all applicable to the adult social care sector:

Best employer of under 250 staff Best employer of over 250 staff Best individual employer who employs their own staff Best provider of learning and development Best employer support for Apprenticeships Best employer support for the assessed and supported year in employment (ASYE) Best recruitment initiatives Most effective new approach to service delivery

To enter Accolades 2013/14 or for more information visit www.skillsforcare.org.uk/accolades. The closing date for nominations is Thursday 5 September 2013.

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